MEDICARE: MR. RICHARD ROBERTS LIMEHOUSE JR. P.T.

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
1	225100000X	Physical Therapist	PT14832	FL

General Provider Information

NPI Number	:	1750501649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD ROBERTS LIMEHOUSE JR. P.T.

Provider Business Mailing Address
First Line	:	67 OLD CHEROKEE WAY
Second Line	:
City	:	DAWSONVILLE
State	:	GA
Zip	:	30534-8626
Country	:	US
Telephone Number	:	706-867-5195
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 OLD CHEROKEE WAY
Second Line	:
City	:	DAWSONVILLE
State	:	GA
Zip	:	30534-8626
Country	:	US
Telephone Number	:	706-867-5195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	11/27/2013

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Directions to “ MR. RICHARD ROBERTS LIMEHOUSE JR. P.T.” Practice Location

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