Provider Demographics
NPI:1679603906
Name:CABLE, ROBERT JOSEPH (ATC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:CABLE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2630
Mailing Address - Country:US
Mailing Address - Phone:304-472-3123
Mailing Address - Fax:
Practice Address - Street 1:1201 LOCUST AVE.
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-367-4273
Practice Address - Fax:304-367-0202
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer