Provider Demographics
NPI:1558463273
Name:ROY, ROBYN SUSAN (PTA)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:SUSAN
Last Name:ROY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:SUSAN
Other - Last Name:HENTHORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 1421
Mailing Address - Street 2:
Mailing Address - City:PINE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91962
Mailing Address - Country:US
Mailing Address - Phone:619-473-8849
Mailing Address - Fax:619-445-5368
Practice Address - Street 1:1385 TAVERN ROAD
Practice Address - Street 2:ALPINE PHYSICAL TEHRAPY AND WELLNESS CENTER INC
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3833
Practice Address - Country:US
Practice Address - Phone:619-445-3168
Practice Address - Fax:619-445-5368
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3553225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant