Provider Demographics
NPI:1720078249
Name:ZIMMERMAN, ROBERT R (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 S ARLINGTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4725
Mailing Address - Country:US
Mailing Address - Phone:330-245-1372
Mailing Address - Fax:330-245-1793
Practice Address - Street 1:85 COMMUNITY RD STE D
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2356
Practice Address - Country:US
Practice Address - Phone:330-630-0630
Practice Address - Fax:330-630-9799
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT03997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT03997OtherOHIO OT PT ATC BOARD
OH2668519Medicaid