Individual
DR. JOHN ORVILLE ROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1691 S BUS HWY 65, HOLLISTER, MO 65672-6342
(417) 336-3210
(417) 336-3201
Mailing address
PO BOX 147, HOLLISTER, MO 65673-0147
(417) 336-3210
(417) 336-3201
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
000740
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00357831
RR MCR
—
Enumeration date
08/12/2005
Last updated
12/06/2007
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