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Individual

CHARLES EUGENE ROBERTS IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
547 E COLUMBUS AVE, BELLEFONTAINE, OH 43311-2480
(937) 210-6818
Mailing address
547 E COLUMBUS AVE, BELLEFONTAINE, OH 43311-2480
(937) 210-6818

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
000870
OH

Other

Enumeration date
06/03/2020
Last updated
06/03/2020
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