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NPI Code Detail

MEDICARE: MR. CARL ROBERTS

MEDICARE:  MR. CARL  ROBERTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT0000128DE

General Provider Information

NPI Number : 1144493081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARL ROBERTS
Provider Business Mailing Address
First Line : 32895 COASTAL HWY
Second Line :
City : BETHANY BEACH
State : DE
Zip : 19930-3782
Country : US
Telephone Number : 302-539-5099
Fax Number : 302-539-8649
Provider Business Practice Location Address
First Line : 32895 COASTAL HWY
Second Line :
City : BETHANY BEACH
State : DE
Zip : 19930-3782
Country : US
Telephone Number : 302-539-5099
Fax Number : 302-539-8649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2008
Last Update Date : 04/11/2008

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Directions to “ MR. CARL ROBERTS ” Practice Location

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