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Individual

DR. JOHN WESLEY ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5201 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-4637
(321) 725-5200
(321) 725-8770
Mailing address
5201 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-4637
(321) 725-5200
(321) 725-8770

Taxonomy

Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CH 5772
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22202
BLUE CROSS BLUE SHEILD NU
FL
Enumeration date
03/29/2007
Last updated
07/08/2007
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