Basic Information
| Provider Information | |||||||||
| NPI: | 1801974035 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSBORN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | KENT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT MTC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 W PACES FERRY RD NW | ||||||||
| Address2: | TERRACE LEVEL | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303051398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708512978 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 BLEACHERY BLVD STE 201 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288038317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286843611 | ||||||||
| FaxNumber: | 8286843612 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 09/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 005434 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | P6365 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.