Provider Demographics
NPI:1124392311
Name:HEAD, ROBERT LEWIS II (DPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEWIS
Last Name:HEAD
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8550 HIDDEN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-3232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3471 LOWERY PKWY STE 107
Practice Address - Street 2:
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068-1681
Practice Address - Country:US
Practice Address - Phone:205-849-6566
Practice Address - Fax:205-849-6563
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist