| Doctor Name: | MISS ELIZABETH MARIE FORTENER |
| NPI Number: | 1316988827 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 1997 |
| Business Practice Address: | 2400 Sumner Blvd Suite 120 Raleigh, NC - 27616 |
| Business Phone Number: | 9198761100 |
| Business Fax Number: | 9198761189 |
| Mailing Address: | 3515 Glenwood Ave, RALEIGH |
| State: | NC |
| Postal Code: | 27612 |
| Phone Number: | 9197815600 |
| Fax Number: | 9197815246 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 11/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 1997 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NV |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |