Individual
MRS. NATALIE ANN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 353-0350
Mailing address
11402 E GORE BLVD, LAWTON, OK 73501-5755
(580) 353-0350
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12016
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12016
STATE LICENSE
OK
Enumeration date
11/11/2006
Last updated
07/08/2007
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