=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245411552
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT M. FRANK LPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2007
-----------------------------------------------------
Last Update Date | 11/12/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 ELIZABETH PL GRAY LEVEL, SUITE A
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45417-3445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-277-2077
-----------------------------------------------------
Fax | 937-277-1600
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 ELIZABETH PL GRAY LEVEL, SUITE A
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45417-3445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-277-2077
-----------------------------------------------------
Fax | 937-277-1600
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 2778
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------