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General NPI Number Information
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NPI Number | 1801974035
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Entity Type | Individual
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Provider Name | ROBERT KENT OSBORN PT MTC
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 1675 CUMBERLAND PKWY SE SUITE 202
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City | SMYRNA
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State | GA
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Zip | 30080
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Country | US
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Telephone | 770-568-7118
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Fax |
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Provider Business Mailing Address
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Address Line | 56 STRICKLAND DR SW
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City | MABLETON
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State | GA
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Zip | 30126-1844
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Country | US
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Telephone | 770-568-7118
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 005434
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License Number State | GA
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