Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | PT24835 | FL |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT24835 | FL |
NPI | 1144533282 |
---|---|
Provider Name | Gregory Allan Robrahn |
First Address | Fort Myers, FL 33919-1625 |
Second Address | Fort Myers, FL 33919-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2010 |
Last Update Date | 19/07/2010 |