Individual
KENNETH W. ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
511 WINDSOR DR, STILLWATER, OK 74074-6962
(405) 707-0900
(405) 707-3363
Mailing address
511 WINDSOR DR, STILLWATER, OK 74074-6962
(405) 707-0900
(405) 707-3363
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
3091
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200069230A
—
OK
Enumeration date
12/02/2005
Last updated
08/13/2008
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