Individual
MR. WILLARD RAY ROBERTS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MORICHES ISLAND RD, EAST MORICHES, NY 11940-1315
(631) 395-4436
(631) 395-4486
Mailing address
100 MORICHES ISLAND RD, EAST MORICHES, NY 11940-1315
(631) 395-4436
(631) 395-4486
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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