Provider Demographics
NPI:1841580552
Name:ROYER, RONSON M (DPT, RDMS, RVT, RT N)
Entity Type:Individual
Prefix:DR
First Name:RONSON
Middle Name:M
Last Name:ROYER
Suffix:
Gender:M
Credentials:DPT, RDMS, RVT, RT N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 RIDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4123
Mailing Address - Country:US
Mailing Address - Phone:478-955-3715
Mailing Address - Fax:205-824-9039
Practice Address - Street 1:551 RIVERSTONE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5292
Practice Address - Country:US
Practice Address - Phone:770-345-2000
Practice Address - Fax:770-345-4524
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009643225100000X
ALPTH5940225100000X
VA2305206137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist