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Dale Forman
NPI 1023432457 · on the registry since 2014 · sole proprietor
Practice
- Address
- 12836 Old Glenn Hwy
Eagle River, AK 99577 - Phone
- (907) 726-5330
- Organisation at this address
- Select Physical Therapy Holdings Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- SC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-02-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska