Individual
DR. RICHARD BOYSEN FORREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
80 23RD AVE N, FORREST CHIROPRACTIC OFFICES, CLINTON, IA 52732-3636
(563) 242-8026
(563) 242-0016
Mailing address
609 BREEZY POINT DR, CLINTON, IA 52732-3636
(563) 241-1074
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04908
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196816
—
IA
01
—
04899
BCBS
IA
01
—
04908
IA LICENSE #
IA
01
—
12819
GROUP #
IA
01
—
350045382
RR MEDICARE
IA
01
—
45-3076673
FEDERAL TAX ID #
IA
01
—
CJ5186
RR MEDICARE GROUP #
IA
Enumeration date
01/19/2006
Last updated
12/27/2011
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