Provider Demographics
NPI:1770295479
Name:PLAGMANN, ROBERT ARTHUR (LMT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ARTHUR
Last Name:PLAGMANN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 LARDRUN LN
Mailing Address - Street 2:
Mailing Address - City:DOLPHIN
Mailing Address - State:VA
Mailing Address - Zip Code:23843-2621
Mailing Address - Country:US
Mailing Address - Phone:757-285-1009
Mailing Address - Fax:
Practice Address - Street 1:336 LARDRUN LN
Practice Address - Street 2:
Practice Address - City:DOLPHIN
Practice Address - State:VA
Practice Address - Zip Code:23843-2621
Practice Address - Country:US
Practice Address - Phone:757-285-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019018219225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist