Individual
MADISON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1159 E US HIGHWAY 54, CAMDENTON, MO 65020-6837
(573) 346-4155
Mailing address
1159 E US HIGHWAY 54, CAMDENTON, MO 65020-6837
(573) 346-4155
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2013034434
MO
Other
Enumeration date
08/31/2014
Last updated
08/31/2014
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