Provider Demographics
NPI:1962465526
Name:BRIGGS, ROBERT ALLAN (DPT, OCS, CSCS, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLAN
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:DPT, OCS, CSCS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MDG/SGHJ
Mailing Address - Street 2:4881 SUGAR MAPLE DRIVE
Mailing Address - City:WPAFB
Mailing Address - State:OH
Mailing Address - Zip Code:43433
Mailing Address - Country:US
Mailing Address - Phone:937-257-8753
Mailing Address - Fax:
Practice Address - Street 1:88 MDG/SGHJ
Practice Address - Street 2:4881 SUGAR MAPLE DRIVE
Practice Address - City:WPAFB
Practice Address - State:OH
Practice Address - Zip Code:43433
Practice Address - Country:US
Practice Address - Phone:937-257-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003028226225100000X
IDPT-2056225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist