Provider Demographics
NPI:1467470831
Name:ROBERTS, WILLIAM JOSEPH JR (MPT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:ROBERTS
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2014
Mailing Address - Country:US
Mailing Address - Phone:609-704-1980
Mailing Address - Fax:609-704-9054
Practice Address - Street 1:640 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2014
Practice Address - Country:US
Practice Address - Phone:609-704-1980
Practice Address - Fax:609-704-9054
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00905900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist