Provider Demographics
NPI:1366648974
Name:KERR, ROBERT ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALAN
Last Name:KERR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 VINCENT ST APT 708
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-4123
Mailing Address - Country:US
Mailing Address - Phone:704-578-8811
Mailing Address - Fax:
Practice Address - Street 1:1216 VINCENT ST APT 708
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4123
Practice Address - Country:US
Practice Address - Phone:704-578-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1157740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist