Provider Demographics
NPI:1245424605
Name:ROBERTS, REBECCA LOVE (PT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LOVE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 ERWIN HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4451
Mailing Address - Country:US
Mailing Address - Phone:423-257-6761
Mailing Address - Fax:
Practice Address - Street 1:901 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2499
Practice Address - Country:US
Practice Address - Phone:423-586-6866
Practice Address - Fax:423-581-9679
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000006491225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist