Provider Demographics
NPI:1336462258
Name:ROBERSON, RHETT ANTHONY (DPT)
Entity Type:Individual
Prefix:
First Name:RHETT
Middle Name:ANTHONY
Last Name:ROBERSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BARRINGTON FARMS PKWY
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-1852
Mailing Address - Country:US
Mailing Address - Phone:706-255-1150
Mailing Address - Fax:
Practice Address - Street 1:6391 ROOSEVELT HWY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830-2281
Practice Address - Country:US
Practice Address - Phone:706-655-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist