Provider Demographics
NPI:1861467813
Name:ROBINSON, WILLIAM WESLEY (ATC, PT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WESLEY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:ATC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:4321 HARTWICK RD STE 101
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3201
Practice Address - Country:US
Practice Address - Phone:301-277-6616
Practice Address - Fax:301-277-6618
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22344225100000X
IN36000719A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer