Provider Demographics
NPI:1720078249
Name:ZIMMERMAN, ROBERT R (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 S ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4725
Mailing Address - Country:US
Mailing Address - Phone:330-245-1372
Mailing Address - Fax:330-245-1793
Practice Address - Street 1:18 TALLMADGE CIR
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2305
Practice Address - Country:US
Practice Address - Phone:330-630-0630
Practice Address - Fax:330-630-9799
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT03997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT03997OtherOHIO OT PT ATC BOARD
OHPT03997OtherOHIO OT PT ATC BOARD