Individual
CHARISSA D ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
48 W COLT SQUARE DR, FAYETTEVILLE, AR 72703-2813
(479) 582-2740
Mailing address
48 W COLT SQUARE DR, FAYETTEVILLE, AR 72703-2813
(479) 582-2740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2600
AR
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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