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Contact Information

FORREST Q PECHA, MS, ATC, LAT, OTC
1109 W MYRTLE ST
SUITE 200
BOISE, ID83702-6970
 Phone: 208-489-4331
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for FORREST Q PECHA · (Male)

NPI # 1639372709
Status Active
Credentials MS, ATC, LAT, OTC
Entity Individual
Enumeration date 06/07/2007
Last updated 06/09/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 02 5855
  • GA License # AT001169
  • ID License # AT-391
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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