Individual
GREGORY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
6815 BROCKHURST BLVD, WEST BLOOMFIELD, MI 48322-1270
(248) 505-7276
Mailing address
6815 BROCKHURST BLVD, WEST BLOOMFIELD, MI 48322-1270
(248) 505-7276
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703115336
MI
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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