Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH2953 | FL |
NPI | 1285748202 |
---|---|
Provider Name | Dr. Hugh H Roberts |
First Address | Lakeland, FL 33813-3508 |
Second Address | Lakeland, FL 33813-3508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 11/10/2011 |