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Individual

FRED JAMES ROBERTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5041 DALLAS HWY, SUITE 500, POWDER SPRINGS, GA 30127-6458
(770) 919-7171
(770) 218-0341
Mailing address
5041 DALLAS HWY, SUITE 500, POWDER SPRINGS, GA 30127-6458
(770) 919-7171
(770) 218-0341

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR005581
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
637180
BLUE CROSS BLUE SHIELD
GA
Enumeration date
03/28/2007
Last updated
07/08/2007
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