NPI 1174772495

Charles Wayne Robertson, PTA

Practitioner Physical Therapy Assistant Poplar Bluff, MO

Practice location

Address: 2725 N Westwood Blvd, Poplar Bluff, MO 63901-2346
Phone: (573) 778-9348
Fax: (573) 778-3463

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 2000161109 (MO)

Other Physical Therapy Assistant providers in Missouri →

Registry record

NPI: 1174772495
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Sep 2008
Record last updated: 10 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.