Provider Demographics
NPI:1902865884
Name:ROBERS, PAMELA KAYE (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:KAYE
Last Name:ROBERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 908063
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-0916
Mailing Address - Country:US
Mailing Address - Phone:770-534-5154
Mailing Address - Fax:770-503-0183
Practice Address - Street 1:2350 LIMESTONE PKWY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2087
Practice Address - Country:US
Practice Address - Phone:770-534-5154
Practice Address - Fax:770-503-0183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT001169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDFKMedicare ID - Type UnspecifiedMEDICARE #
GAQ52127Medicare UPIN