Provider Demographics
NPI:1982931366
Name:STANSBERRY, ROBERT G (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:STANSBERRY
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 1:307 CARPENTER DAM RD STE L
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8282
Mailing Address - Country:US
Mailing Address - Phone:501-623-6353
Mailing Address - Fax:
Practice Address - Street 1:307 CARPENTER DAM RD STE L
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8282
Practice Address - Country:US
Practice Address - Phone:501-623-6353
Practice Address - Fax:501-321-4783
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist