Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Wayne Robertson, PTA

Individual provider Physical Therapy Assistant · NPI 1174772495

Charles Wayne Robertson, PTA is a Physical Therapy Assistant in Poplar Bluff, Missouri. Licensed in Missouri. Registered with an NPI since 2008.

Licensed in
MO
In the registry since
2008
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

2725 N Westwood Blvd
Poplar Bluff, MO 63901-2346
Phone: (573) 778-9348
Fax: (573) 778-3463
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2000161109 (MO)

Record details

NPI number1174772495
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedSeptember 10, 2008
Last updated in NPPESSeptember 10, 2008
Mailing address2725 N Westwood Blvd, Poplar Bluff, MO 63901-2346

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