Roberts, Jack T.

Roberts, Jack T. is an individual health care provider with primary practice located at 1680 Cooper Foster Park Rd W Suite A, Lorain OH 44053-3657. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Roberts, Jack T. can be contacted via phone (440) 989-1133.

Contact Information

Primary practice address
1680 Cooper Foster Park Rd W Suite A Lorain OH 44053-3657
Phone: (440) 989-1133
Fax: (440) 989-1137
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X A00803 Ohio

Profile Details

NPI number 1376592667
LBN Legal business name Roberts, Jack T.
Credentials AU.D
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Apr 8th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376592667 NPPES
Ohio MEDICAID 0883076

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