Individual
JOHN ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1102 LARKSPUR LN, CLEBURNE, TX 76033-4672
(254) 337-0986
Mailing address
1102 LARKSPUR LN, CLEBURNE, TX 76033-4672
(254) 337-0986
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1300
TEXAS DEPARTMENT OF HEALTH
TX
Enumeration date
05/23/2022
Last updated
05/23/2022
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