Individual
FRANK E FORTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDIV, QMHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
Mailing address
1204 METROPOLIS ST, METROPOLIS, IL 62960-1308
(618) 524-5736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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