Provider Demographics
NPI:1780779157
Name:SUGGETT, ROBERT GARY (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GARY
Last Name:SUGGETT
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 1:1121 MAIDU DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5808
Mailing Address - Country:US
Mailing Address - Phone:916-747-7562
Mailing Address - Fax:530-888-8832
Practice Address - Street 1:1121 MAIDU DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5808
Practice Address - Country:US
Practice Address - Phone:916-747-7562
Practice Address - Fax:530-888-8832
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 89292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic