Individual
LORI ROAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5047 VIRGINIA AVE, BLDG 500, FORT LEONARD WOOD, MO 65473-9126
(573) 596-0408
Mailing address
4TH WEST & VIRGINIA AVE, BLDG 500, FORT LEONARD WOOD, MO 65473
(573) 596-0408
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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