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General NPI Number Information
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NPI Number | 1477872216
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Entity Type | Individual
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Provider Name | ROBERT BARRY DALE PT
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Gender | Male
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 920 MADISON AVENUE SUITE 415
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City | MEMPHIS
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State | TN
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Zip | 38163-0002
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Country | US
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Telephone | 901-448-3356
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Fax |
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Provider Business Mailing Address
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Address Line | 3062 BRIDGE MOORE DR
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City | NESBIT
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State | MS
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Zip | 38651-8387
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Country | US
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Telephone | 901-448-3356
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 3656
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PTH7317
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 3656
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License Number State | TN
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