Provider Demographics
NPI:1407892979
Name:HENSLEY, ROBERT A
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 SE ISABELL RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-8865
Mailing Address - Country:US
Mailing Address - Phone:772-335-7073
Mailing Address - Fax:772-398-2632
Practice Address - Street 1:2071 SE ISABELL RD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-8865
Practice Address - Country:US
Practice Address - Phone:772-335-7073
Practice Address - Fax:772-398-2632
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 4728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist