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Individual
MR. TIMOTHY MALCOM ROBERTSON
Active
Individual
MR. TIMOTHY MALCOM ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCA
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810027474
PROVIDER ID
—
Enumeration date
12/08/2017
Last updated
12/08/2017
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