Individual
MARY ROBERTSON LAFAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
117 E KINGS HWY, EDEN, NC 27288-5201
(336) 623-9711
Mailing address
404 RIDGEWAY DR, GREENSBORO, NC 27403-1531
(336) 988-5305
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6503
NC
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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