MR. Roger Olen Kollock JR., ATC
NPI #1922057264 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1922057264
- Entity Type
- Individual
- Name
- MR. Roger Olen Kollock JR., ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- May 5, 2006
- Last Updated
- Dec 27, 2019
Practice Location
- Address
- 2405 S 14TH ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-7263
- Phone
- (423) 943-1528
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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