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General NPI Number Information
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NPI Number | 1336002971
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Entity Type | Individual
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Provider Name | TARA ROBERTS
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 730 W BERTRAND AVE
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City | SAINT MARYS
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State | KS
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Zip | 66536-1645
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Country | US
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Telephone | 785-844-1816
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Fax |
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Provider Business Mailing Address
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Address Line | 540 WICKHAM RD
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City | MANHATTAN
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State | KS
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Zip | 66502-3753
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-01355
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License Number State | KS
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