Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ROGER OLEN KOLLOCK JR., ATC
Active Sole ProprietorMR. ROGER OLEN KOLLOCK JR., ATC is a Athletic Trainer healthcare provider located in BROKEN ARROW, Oklahoma. NPI 1922057264 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · BROKEN ARROW, OK
Registration Details
- NPI Number
- 1922057264
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 5, 2006 (20.263612431794 yrs)
- Last Updated
- Dec 27, 2019
- License
-
AT1084 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2405 S 14TH STBROKEN ARROW, OK, 740127263Browse OK providers · Browse ZIP 74012
- Phone
- 4239431528
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in BROKEN ARROW, OK
| Name | Credential | NPI |
|---|---|---|
| JERRY ALLEN QUINTON | — | 1740883057 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.