Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT5237 | FL |
NPI | 1003156779 |
---|---|
Provider Name | Beth Ann Roberts |
First Address | Easton, PA 18040-7958 |
Second Address | Sunrise, FL 33351-6163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2013 |
Last Update Date | 18/02/2013 |