Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Roger Olen Kollock Jr., ATC

Individual provider Athletic Trainer · NPI 1922057264

Mr. Roger Olen Kollock Jr., ATC is an Athletic Trainer in Broken Arrow, Oklahoma. Practices as a sole proprietor and works from 2 locations. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2006
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

2405 S 14th St
Broken Arrow, OK 74012-7263
Phone: (423) 943-1528
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1440 Suncrest Dr, Gray, TN 37615-4118 — (423) 477-1600

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT1084 (OK)

Record details

NPI number1922057264
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedMay 5, 2006
Last updated in NPPESDecember 27, 2019
Certification dateDecember 27, 2019

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