NPI 1629502968

Earl Robertson, CPLPO

Practitioner Prosthetist Memphis, TN

Practice location

Address: 722 N White Station Rd, Memphis, TN 38122-4422
Phone: (901) 763-6999
Fax: (901) 682-9062

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence LP 49 (TN)

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence LO 58 (TN)

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Registry record

NPI: 1629502968
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Apr 2017
Record last updated: 13 Apr 2017

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.