Provider Demographics
NPI:1962866640
Name:RAMOS, ROBERT (ATC EMT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:ATC EMT
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC EMT
Mailing Address - Street 1:1137 SFH
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84602-2246
Mailing Address - Country:US
Mailing Address - Phone:801-422-5142
Mailing Address - Fax:
Practice Address - Street 1:1137 SFH
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602-2246
Practice Address - Country:US
Practice Address - Phone:801-422-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer