Provider Demographics
NPI:1285782821
Name:ROBYN PESTER PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:ROBYN PESTER PHYSICAL THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-344-6744
Mailing Address - Street 1:401 E 10TH AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3317
Mailing Address - Country:US
Mailing Address - Phone:541-344-6744
Mailing Address - Fax:541-686-3468
Practice Address - Street 1:401 E 10TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3317
Practice Address - Country:US
Practice Address - Phone:541-344-6744
Practice Address - Fax:541-686-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR327803000001OtherPROVIDENCE
OR067013000OtherBLUE CROSS
OR327803000001OtherPROVIDENCE