Provider Demographics
NPI:1427459015
Name:PRECHT, ROBERT WILLIAM III (DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:PRECHT
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29525 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2319
Mailing Address - Country:US
Mailing Address - Phone:734-522-0065
Mailing Address - Fax:734-522-0068
Practice Address - Street 1:29525 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2319
Practice Address - Country:US
Practice Address - Phone:734-522-0065
Practice Address - Fax:734-522-0068
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KY006468225100000X
WV003327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501017651OtherLICENSE