Healthcare Provider Details

I. General information

NPI: 1235238924
Provider Name (Legal Business Name): ROBERT KANE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 FRANKLIN ST
WEYERS CAVE VA
24486-2340
US

IV. Provider business mailing address

54 FRANKLIN ST
WEYERS CAVE VA
24486-2340
US

V. Phone/Fax

Practice location:
  • Phone: 540-234-8800
  • Fax: 540-234-8939
Mailing address:
  • Phone: 540-234-8800
  • Fax: 540-234-8939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305202864
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: