Individual
SHAUN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
207 W MAIN ST, PORTLAND, IN 47371-2124
(260) 726-9661
Mailing address
1332 S MERIDIAN ST, PORTLAND, IN 47371-2806
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002771A
IN
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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