Individual
KACIE MARIE ROBICHAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
161 COLUMBIA ROAD 53, WALDO, AR 71770-9670
(870) 904-0295
Mailing address
161 COLUMBIA ROAD 53, WALDO, AR 71770-9670
(870) 904-0295
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-2514
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PTA-2514
—
AR
Enumeration date
04/29/2019
Last updated
04/29/2019
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