Provider Demographics
NPI:1902308216
Name:PETRUZZI, ROBIN LEE (LPT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:PETRUZZI
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 SIOUAN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-8571
Mailing Address - Country:US
Mailing Address - Phone:336-596-3745
Mailing Address - Fax:
Practice Address - Street 1:374 SIOUAN DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-8571
Practice Address - Country:US
Practice Address - Phone:336-596-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist