Individual
KYLE G ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C. PED.
Contact information
Practice address
W314S2556 PENNY LN, WALES, WI 53183-9671
(262) 968-3643
Mailing address
W314S2556 PENNY LN, WALES, WI 53183-9671
(262) 968-3643
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
05/01/2008
Last updated
05/02/2008
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