Basic Information
| Provider Information | |||||||||
| NPI: | 1275684573 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORBES | ||||||||
| FirstName: | KRIS | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 695 | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 406020695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022263858 | ||||||||
| FaxNumber: | 5022239829 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 GLENSBORO RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403429084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028399755 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2007 | ||||||||
| LastUpdateDate: | 09/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 004080 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 371498135 | 01 | KY | BLUEGRASS FAMILY HEALTH | OTHER | 1189025 | 01 | KY | CHA | OTHER | 000000368088 | 01 | KY | ANTHEM BLUE CROSS | OTHER | 7019684 | 01 | KY | AETNA | OTHER |