Provider Demographics
NPI:1720897622
Name:ROBLES, JORGE EMMANUEL (DC)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:EMMANUEL
Last Name:ROBLES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 FIVE FORKS TRICKUM RD SW STE 7N
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-1874
Mailing Address - Country:US
Mailing Address - Phone:787-501-6258
Mailing Address - Fax:770-268-2978
Practice Address - Street 1:3035 FIVE FORKS TRICKUM RD SW STE 7
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1874
Practice Address - Country:US
Practice Address - Phone:787-501-6258
Practice Address - Fax:770-268-2978
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor