Organization
ROBERTA J PEREGRINE
Active
Other names
Second to Nature
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA J PEREGRINE (OWNER)
(816) 387-8858
Entity
Organization
Contact information
Practice address
2602 FREDERICK AVE, STE A, SAINT JOSEPH, MO 64506-2840
(816) 387-8858
(816) 387-8858
Mailing address
2602 FREDERICK AVE, STE A, SAINT JOSEPH, MO 64506-2847
(816) 387-8858
(816) 387-8858
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27826022
BLUECROSS BLUESHIELD
MO
Enumeration date
03/19/2008
Last updated
03/19/2008
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