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General NPI Number Information
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NPI Number | 1962988709
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Entity Type | Organization
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Legal Business Name | ROBERTS INTEGRATIVE MEDICINE, LLC
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 1710 GALLATIN PIKE N
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City | MADISON
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State | TN
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Zip | 37115-2122
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Country | US
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Telephone | 615-645-0994
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Fax | 615-915-0389
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Provider Business Mailing Address
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Address Line | 1710 GALLATIN PIKE N
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City | MADISON
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State | TN
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Zip | 37115-2122
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Country | US
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Telephone | 615-645-0994
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Fax | 615-915-0389
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD ANDREW ROBERTS
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Credential | DC
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Telephone | 615-995-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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