Provider Demographics
NPI:1114666831
Name:ROOT, ERIN M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:M
Last Name:ROOT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 OSIGIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8958
Mailing Address - Country:US
Mailing Address - Phone:478-953-3535
Mailing Address - Fax:478-953-0353
Practice Address - Street 1:405 OSIGIAN BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8958
Practice Address - Country:US
Practice Address - Phone:478-953-3535
Practice Address - Fax:478-953-0353
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist