Individual
DR. LEONARD E FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1106 CHUCK DAWLEY BLVD, SUITE 200, MT PLEASANT, SC 29464-4183
(800) 741-6920
Mailing address
217 DOZIER BLVD, SUITE 100, FLORENCE, SC 29501-4090
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
16939
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169392
—
SC
01
—
320058385
STANDARD TAX ID
SC
Enumeration date
12/09/2005
Last updated
11/09/2009
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