Healthcare Provider Details

I. General information

NPI: 1033128707
Provider Name (Legal Business Name): ROBIN GLOVER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 COURT STREET STES A-C PROFESSIONAL BUILDING
APPOMATTOX VA
24522
US

IV. Provider business mailing address

20311 TIMBERLAKE RD STE B
LYNCHBURG VA
24502-7203
US

V. Phone/Fax

Practice location:
  • Phone: 434-845-9053
  • Fax:
Mailing address:
  • Phone: 434-845-9053
  • Fax: 434-528-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203346
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: