Provider Demographics
NPI:1831855642
Name:POWERS, ROBERT PATRICK III
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:POWERS
Suffix:III
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 1:6878 AUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48767-9433
Mailing Address - Country:US
Mailing Address - Phone:989-415-2407
Mailing Address - Fax:
Practice Address - Street 1:3727 DEEP RIVER RD
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-9458
Practice Address - Country:US
Practice Address - Phone:989-415-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician