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General NPI Number Information
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NPI Number | 1881201218
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Entity Type | Individual
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Provider Name | ROBERT ARTHUR LMT
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Gender | Male
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 205 E PEARL ST UNIT B
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City | GRANBURY
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State | TX
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Zip | 76048-2212
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Country | US
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Telephone | 817-980-8292
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Fax |
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Provider Business Mailing Address
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Address Line | 4514 OVERLOOK CT
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City | GRANBURY
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State | TX
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Zip | 76049-7207
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Country | US
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Telephone | 817-894-0743
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT044424
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License Number State | TX
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