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Individual

JACOB WESLEY ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
411 THEATRE DR, JOHNSTOWN, PA 15904-2838
(814) 266-3934
Mailing address
411 THEATRE DR, JOHNSTOWN, PA 15904-2838
(814) 266-3934
(814) 266-3934

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0001235
DE
363A00000X
Physician Assistant
Primary
MA061665
PA

Other

Enumeration date
08/20/2018
Last updated
06/13/2024
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