Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2670 | AZ |
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1013094473 |
---|---|
Provider Name | Robert J. Henert |
First Address | Tempe, AZ 85284-2819 |
Second Address | Phoenix, AZ 85044-6691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |