Provider Demographics
NPI:1518183276
Name:ROBERTS, MICHELE LILLIAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LILLIAN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6535 E SUPERSTITION SPRINGS BLVD
Mailing Address - Street 2:UNIT 235
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4377
Mailing Address - Country:US
Mailing Address - Phone:480-313-3838
Mailing Address - Fax:
Practice Address - Street 1:2302 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-1201
Practice Address - Country:US
Practice Address - Phone:602-265-4124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist