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General NPI Number Information
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NPI Number | 1912672593
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Entity Type | Individual
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Provider Name | SHAWN MICHAEL ROBERTS PHYSICAL THERAPY
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Gender | Male
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Dates
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Enumeration Date | 08/15/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 41 HITCHCOCK WAY
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3174
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Country | US
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Telephone | 805-682-2536
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Fax |
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Provider Business Mailing Address
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Address Line | 3968 GREENBUSH RD
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City | CHARLOTTE
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State | VT
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Zip | 05445-9306
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Country | US
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Telephone | 802-735-7511
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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 | 040.0134263
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License Number State | VT
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