Individual
JASON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(491) 228-3335
Mailing address
6427 RING NECK DR, DAYTON, OH 45424-4198
(937) 409-1321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.15901-NP
OH
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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