Provider Demographics
NPI:1750336418
Name:POOLOS, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:POOLOS
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 1:4041 W SYLVANIA AVE
Mailing Address - Street 2:SUITE L004 TOLEDO ORTHOPEDIC REHABILITATION
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4465
Mailing Address - Country:US
Mailing Address - Phone:419-474-4781
Mailing Address - Fax:419-474-8372
Practice Address - Street 1:4041 W SYLVANIA AVE
Practice Address - Street 2:SUITE L004 TOLEDO ORTHOPEDIC REHABILITATION
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4465
Practice Address - Country:US
Practice Address - Phone:419-474-4781
Practice Address - Fax:419-474-8372
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT009457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist