Provider Demographics
NPI:1457316903
Name:ROBERTS, GINGER C (PT)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:C
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 1:451 COUNTY ROAD 854
Mailing Address - Street 2:
Mailing Address - City:HEFLIN
Mailing Address - State:AL
Mailing Address - Zip Code:36264-3720
Mailing Address - Country:US
Mailing Address - Phone:256-253-2847
Mailing Address - Fax:
Practice Address - Street 1:651 SNOW ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-1212
Practice Address - Country:US
Practice Address - Phone:256-241-7500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-03005Medicare ID - Type UnspecifiedPROVIDER NUMBER
AL515-03004Medicare ID - Type UnspecifiedPROVIDER NUMBER