Individual
JOANN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8200 ROGUE RIVER HWY, 950 SW 6TH. ST. SUITE #25, GRANTS PASS, OR 97527-4349
(541) 821-9299
Mailing address
8200 ROGUE RIVER HWY, GRANTS PASS, OR 97527-4349
(541) 821-9299
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LMT #15469
OR
174400000X
Specialist
LMT #115469
OR
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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