Johnathan Charles Roberts
Specialist/Technologist in Marietta, GA. Individual provider (NPI-1).
NPI number1669997276
StatusActive
Last updated in NPPESAug 4, 2017
Details
- NPI
- 1669997276
- Entity type
- Individual (NPI-1)
- Name
- Johnathan Charles Roberts
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 4, 2017
- Last updated
- Aug 4, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225500000X | Specialist/Technologist | – | – | Yes |
Practice location
2855 Julias Way NwMarietta, GA 30064-6219
Phone 770-218-0776 · Fax 303-922-4640
Mailing address
Po Box 986Acworth, GA 30101-0986
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