Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1286442 | TX |
NPI | 1023529435 |
---|---|
Provider Name | Mrs. Kathryn Jo Roby |
First Address | Abilene, TX 79602-8228 |
Second Address | Eastland, TX 76448-2609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2017 |
Last Update Date | 13/06/2019 |