Provider Demographics
NPI:1669547741
Name:ESSEX, ROBERT LEE (PT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:ESSEX
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2545 CAPITAL AVE SW STE 140
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7103
Mailing Address - Country:US
Mailing Address - Phone:269-979-3000
Mailing Address - Fax:269-979-9770
Practice Address - Street 1:2545 CAPITAL AVE SW STE 140
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7103
Practice Address - Country:US
Practice Address - Phone:269-979-3000
Practice Address - Fax:269-979-9770
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004402225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N18350Medicare ID - Type Unspecified