Individual
GARRY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1065 E 9TH ST, LOCKPORT, IL 60441-3567
(815) 588-1366
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003924
IL
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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