MEDICARE: MR. ROBERT ALAN HENSON P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT02844L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	251570641	OTHER	PA	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457389330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT ALAN HENSON P.T.

Provider Business Mailing Address
First Line	:	ROUTE 51 & JANET STREET
Second Line	:	PO BOX 301
City	:	PERRYOPOLIS
State	:	PA
Zip	:	15473
Country	:	US
Telephone Number	:	724-736-7415
Fax Number	:	724-736-7416

Provider Business Practice Location Address
First Line	:	ROUTE 51 & JANET STREET
Second Line	:
City	:	PERRYOPOLIS
State	:	PA
Zip	:	15473
Country	:	US
Telephone Number	:	724-736-7415
Fax Number	:	724-736-7416

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	02/11/2009

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