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Organization

GRACE FORSYTHE PHD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GRACE A FORSYTHE PHD, APRN (PRESIDENT)
(801) 273-7769
Entity
Organization

Contact information

Practice address
2046 MURRAY HOLLADAY RD, 103, SALT LAKE CITY, UT 84117-5125
(801) 273-7769
(801) 273-4073
Mailing address
4271 NEPTUNE DR, SALT LAKE CITY, UT 84124-3362
(801) 273-7769
(801) 273-4073

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2189134405
UT

Other

Enumeration date
11/07/2006
Last updated
12/31/2010
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