Individual
MAXWELL ALAN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2613 8TH AVE SE, WATERTOWN, SD 57201-9137
(605) 237-5679
Mailing address
2613 8TH AVE SE, WATERTOWN, SD 57201-9137
(605) 880-1248
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT12008
SD
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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