Individual
MR. JOHN LARRY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-5086
Mailing address
2518 RIVER COVE DR, RIVERBANK, CA 95367-3332
(707) 497-4659
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
505769
—
Other
Enumeration date
11/22/2011
Last updated
01/04/2013
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