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General NPI Number Information
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NPI Number | 1417671819
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Entity Type | Individual
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Provider Name | ROBERT JAMES YARBROUGH JR. PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1908 W MILHAM AVE
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City | PORTAGE
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State | MI
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Zip | 49024-1232
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Country | US
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Telephone | 269-459-6212
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Fax |
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Provider Business Mailing Address
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Address Line | 33555 M 40
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City | PAW PAW
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State | MI
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Zip | 49079-8574
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Country | US
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Telephone | 269-251-2363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501302267
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License Number State | MI
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