Individual
MR. JAMIE LENN ROBERTS
Active
Individual
MR. JAMIE LENN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
32955
CA
225100000X
Physical Therapist
Primary
6900
TN
225100000X
Physical Therapist
9780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3650014
—
TN
01
—
4158705
BCBS
TN
01
—
CH4394
MEDICARE-RAILROAD GROUP ID
TN
Enumeration date
11/21/2006
Last updated
06/24/2010
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