Individual
MRS. ROBERTA RAE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ETC
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 662-4718
Mailing address
PHS INDIAN HOSPITAL, 12033 AGENCY RD, PARKER, AR 85344-9703
(928) 662-4718
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
AZ
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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