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Individual

MS. ROBERTA JEAN SAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
401 E. PICACHO ROAD, WINTERHAVEN, CA 92283
(760) 572-4120
(760) 572-2117
Mailing address
1600 W. 12TH ST, APT 624, YUMA, AZ 85364-9000
(623) 296-6027
(760) 572-2117

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T9Y4D2D2
KS

Other

Enumeration date
09/14/2018
Last updated
09/14/2018
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