Individual
SANDRA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
455 N 19TH ST, MUSKOGEE, OK 74401-3020
(918) 310-8026
Mailing address
455 N 19TH ST, MUSKOGEE, OK 74401-3020
(918) 310-8026
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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