Provider Demographics
NPI:1407882657
Name:HUGLI, ROBERT BRYAN (LPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRYAN
Last Name:HUGLI
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 961
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-0961
Mailing Address - Country:US
Mailing Address - Phone:912-764-9951
Mailing Address - Fax:912-489-4808
Practice Address - Street 1:23630 US HIGHWAY 80 E # B
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461-6019
Practice Address - Country:US
Practice Address - Phone:912-764-9951
Practice Address - Fax:912-489-4808
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ64418Medicare UPIN
GA65BBDLKMedicare ID - Type Unspecified