Individual
ROBERTA J PEREGRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2602 FREDERICK AVE, STE A, SAINT JOSEPH, MO 64506-2840
(816) 387-8858
(816) 387-8858
Mailing address
2602 FREDERICK AVE, STE A, SAINT JOSEPH, MO 64506-2847
(816) 387-8858
(816) 387-8858
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27826022
BLUECROSSBLUESHIELD
MO
Enumeration date
11/02/2005
Last updated
03/18/2008
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