Individual
JAY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 HIGHWAY 142, POPLAR BLUFF, MO 63901-8159
(573) 776-2450
(573) 776-2455
Mailing address
725 HIGHWAY 142, POPLAR BLUFF, MO 63901-8159
(573) 776-2450
(573) 776-2455
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1999135773
MO
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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