Individual
LEVI ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4779 GUYAN RIVER RD, SALT ROCK, WV 25559
(304) 733-1112
Mailing address
RR 2 BOX 450A, SALT ROCK, WV 25559-9605
(304) 633-8510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WV
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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