Provider Demographics
NPI:1881142743
Name:ROSS, ROBYN LEA (MPT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:LEA
Last Name:ROSS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:LEA
Other - Last Name:LOUGHRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:700 NW 7TH ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1212
Mailing Address - Country:US
Mailing Address - Phone:405-609-3675
Mailing Address - Fax:800-506-3795
Practice Address - Street 1:300 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6300
Practice Address - Country:US
Practice Address - Phone:405-387-4220
Practice Address - Fax:405-387-4222
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist