Provider Demographics
NPI:1295783397
Name:ROBERTS, TERRY L JR (DPT)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:L
Last Name:ROBERTS
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ESTERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4001
Mailing Address - Country:US
Mailing Address - Phone:856-751-8899
Mailing Address - Fax:
Practice Address - Street 1:5 ESTERBROOK LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4001
Practice Address - Country:US
Practice Address - Phone:856-751-8899
Practice Address - Fax:856-751-1075
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA017785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist