Provider Demographics
NPI:1164610382
Name:ROBARE, KRISTI ANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:ANNE
Last Name:ROBARE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S MUSTANG RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7315
Mailing Address - Country:US
Mailing Address - Phone:405-324-0961
Mailing Address - Fax:405-324-0971
Practice Address - Street 1:424 S MUSTANG RD
Practice Address - Street 2:SUITE B
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7315
Practice Address - Country:US
Practice Address - Phone:405-324-0961
Practice Address - Fax:405-324-0971
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist