Provider Demographics
NPI:1780776492
Name:ROBLESKI, KRYSTLE L (L, ATC)
Entity type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:L
Last Name:ROBLESKI
Suffix:
Gender:F
Credentials:L, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WALKER RD APT 11
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1957
Mailing Address - Country:US
Mailing Address - Phone:978-683-6364
Mailing Address - Fax:
Practice Address - Street 1:9 WALKER RD APT 11
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1957
Practice Address - Country:US
Practice Address - Phone:978-683-6364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1545171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor