Individual
MR. JASON TREVOR ROBERTS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
1000 ELYSIAN PARK AVE, LOS ANGELES, CA 90012-1112
(323) 224-1500
Mailing address
509 STATE ST, SCRANTON, IA 51462-8418
(772) 559-5703
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1543
FL
Other
Enumeration date
12/15/2005
Last updated
07/08/2007
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