Provider Demographics
NPI:1003460015
Name:ROBERTS, MARCUS (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5906
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31758-5906
Mailing Address - Country:US
Mailing Address - Phone:229-236-8989
Mailing Address - Fax:229-236-8990
Practice Address - Street 1:223 S CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5504
Practice Address - Country:US
Practice Address - Phone:229-236-8989
Practice Address - Fax:229-238-8990
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist