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Individual

ROBERT S BANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1701 N PATTERSON ST, VALDOSTA, GA 31602-2940
(229) 574-5047
Mailing address
1701 N PATTERSON ST, VALDOSTA, GA 31602-2940

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006804
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267658369A
GA
Enumeration date
04/30/2008
Last updated
04/30/2008
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