Provider Demographics
NPI:1679692990
Name:ROBINETT-EBERT, PAMELA ROSCHEL (PT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ROSCHEL
Last Name:ROBINETT-EBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10091 WELLMAN RD
Mailing Address - Street 2:
Mailing Address - City:MC LOUTH
Mailing Address - State:KS
Mailing Address - Zip Code:66054-5066
Mailing Address - Country:US
Mailing Address - Phone:785-863-3582
Mailing Address - Fax:
Practice Address - Street 1:1821 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-1437
Practice Address - Country:US
Practice Address - Phone:785-234-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist