Individual
MR. STACEY O ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
700 S SYCAMORE ST STE 7, PETERSBURG, VA 23803-5804
(804) 722-0317
Mailing address
700 S SYCAMORE ST STE 7, PETERSBURG, VA 23803-5804
(804) 722-0317
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019005592
VA
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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