Individual
MRS. CAROLINE N ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PTA
Contact information
Practice address
470 E LOCKWOOD AVE, SAINT LOUIS, MO 63119-3194
(630) 876-6286
Mailing address
5065 GALENA CT, IMPERIAL, MO 63052-1587
(618) 593-5820
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
160007639
IL
225200000X
Physical Therapy Assistant
2018027218
MO
2255A2300X
Athletic Trainer
096004237
IL
2255A2300X
Athletic Trainer
Primary
2018027217
MO
Other
Enumeration date
03/16/2018
Last updated
01/25/2022
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