Individual
MR. CHAD ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
50 TOWN CT, PALM COAST, FL 32164-2589
(386) 313-5974
(866) 647-2045
Mailing address
PO BOX 1975, ROME, GA 30162-1975
(706) 236-2755
(866) 647-2045
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT007632
GA
225100000X
Physical Therapist
Primary
PT19497
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
975142262A
—
GA
05
—
975142262C
—
GA
01
—
P00316287
RR MEDICARE
GA
Enumeration date
05/10/2006
Last updated
08/04/2014
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