Provider Demographics
NPI:1932303401
Name:PRATER, ROBIN RACHEL (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:RACHEL
Last Name:PRATER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:RACHEL
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPTA
Mailing Address - Street 1:24152 CR EW 180
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:OK
Mailing Address - Zip Code:73528
Mailing Address - Country:US
Mailing Address - Phone:580-597-3044
Mailing Address - Fax:
Practice Address - Street 1:4411 WEST GORE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-585-5575
Practice Address - Fax:580-585-5597
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKTA546225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant