Individual
MR. ZACHARY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4450 CAMP SWIFT RD, FORT DRUM, NY 13602
(315) 772-6730
Mailing address
811 TAMARACK DR APT D, CARTHAGE, NY 13619-9568
(906) 236-1042
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
115204
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2015
Last updated
11/08/2022
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