Individual
LARRY WAYNE ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED MASSAGE
Contact information
Practice address
116 E SOUTH ST, LONGVIEW, TX 75601-7437
(903) 230-1911
Mailing address
116 E SOUTH ST, LONGVIEW, TX 75601-7437
(903) 230-1911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT037344
TX
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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