Provider Demographics
NPI:1376968024
Name:ROYBAL, JOANNA (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:ROYBAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 S KEWAUNEE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4327
Mailing Address - Country:US
Mailing Address - Phone:303-358-8137
Mailing Address - Fax:
Practice Address - Street 1:6617 S KEWAUNEE WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-4327
Practice Address - Country:US
Practice Address - Phone:303-358-8137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist