Provider Demographics
NPI:1912378621
Name:ALSTERBERG, ROBERT (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ALSTERBERG
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 NIMITZ CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-3957
Mailing Address - Country:US
Mailing Address - Phone:615-792-7006
Mailing Address - Fax:615-792-7006
Practice Address - Street 1:102 NIMITZ CIR
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-3957
Practice Address - Country:US
Practice Address - Phone:615-792-7006
Practice Address - Fax:615-792-7006
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA0000001220171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor