Provider Demographics
NPI:1255896700
Name:SALES, ROBERT L
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:SALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 WELCH RD
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:GA
Mailing Address - Zip Code:31803-8901
Mailing Address - Country:US
Mailing Address - Phone:229-815-1744
Mailing Address - Fax:
Practice Address - Street 1:198 WELCH RD
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:GA
Practice Address - Zip Code:31803-8901
Practice Address - Country:US
Practice Address - Phone:229-815-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer