Individual
NICHOLAS FORSYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2499 E JOLIET HWY, UNIT 112, NEW LENOX, IL 60451-2592
(815) 462-9420
(815) 462-9421
Mailing address
25561 OCONNEL LN, MANHATTAN, IL 60442-6241
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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