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Individual

DR. JACOB BENJAMIN ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1542 ELK CREEK DR, SUITE B, IDAHO FALLS, ID 83404-8322
(208) 521-7336
Mailing address
1169 WASHBURN AVE, IDAHO FALLS, ID 83402-1607
(208) 521-7336

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT - 2217
ID

Other

Enumeration date
06/12/2007
Last updated
07/31/2007
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