Individual
OLIVIA C ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
3533 SOUTHERN BLVD., STE. 2100, KETTERING, OH 45429-1267
(937) 395-8556
(937) 395-6376
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004119RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110469
—
OH
Enumeration date
09/12/2014
Last updated
04/12/2022
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