Individual
MARY ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
105 N KEENE ST STE 201, COLUMBIA, MO 65201-8131
(573) 499-4990
(573) 442-2120
Mailing address
105 N KEENE ST STE 201, COLUMBIA, MO 65201-8131
(573) 499-4990
(573) 442-2120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/15/2022
Last updated
07/24/2023
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