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Individual

MR. ROBERT CATLIN PENDLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2301 BELL AVE, ELK CITY, OK 73644-2254
(405) 757-5694
Mailing address
525 N 2ND ST, WEATHERFORD, OK 73096-4403
(405) 757-5694

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2536
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H080765781
OKLAHOMA DRIVER'S LICENSE
OK
Enumeration date
05/21/2017
Last updated
05/21/2017
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