Healthcare Provider Details

I. General information

NPI: 1689955734
Provider Name (Legal Business Name): BOBI JO ROBLES P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E. COLLEGE DRIVE
COLBY KS
67701
US

IV. Provider business mailing address

100 E. COLLEGE DRIVE
COLBY KS
67701
US

V. Phone/Fax

Practice location:
  • Phone: 785-460-4868
  • Fax: 785-460-4870
Mailing address:
  • Phone: 785-460-4868
  • Fax: 785-460-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-03928
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: