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General NPI Number Information
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NPI Number | 1689672727
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Entity Type | Individual
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Provider Name | ROBERT G CARUSO PT
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 2236 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73069-6462
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Country | US
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Telephone | 405-321-5969
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Fax | 405-321-5967
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Provider Business Mailing Address
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Address Line | 825 N BROADWAY AVE SUITE 400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-6039
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Country | US
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Telephone | 405-609-3697
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Fax | 405-605-8638
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | AT172
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT2090
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License Number State | OK
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