Individual
MR. EARL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP, LPO
Contact information
Practice address
722 N WHITE STATION RD, MEMPHIS, TN 38122-4422
(901) 763-6999
(901) 682-9062
Mailing address
722 N WHITE STATION RD, MEMPHIS, TN 38122-4422
(901) 763-6999
(901) 682-9062
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
LO 58
TN
224P00000X
Prosthetist
Primary
LP 49
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP 1357
ABC
—
Enumeration date
04/13/2017
Last updated
04/13/2017
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