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General NPI Number Information
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NPI Number | 1720950017
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Entity Type | Individual
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Provider Name | ROBERTO I SANTA DC
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Gender | Male
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 468 HIGHWAY 53 E STE 140
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City | CALHOUN
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State | GA
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Zip | 30701-3055
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Country | US
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Telephone | 706-459-9456
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Fax | 706-229-0012
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Provider Business Mailing Address
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Address Line | 1194 TOWNSHIP PL APT 202
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City | DALTON
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State | GA
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Zip | 30721-1569
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Country | US
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Telephone | 706-459-9456
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Fax | 706-229-0012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR066559
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License Number State | GA
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