Individual
MRS. TWILA ALISA ROULHAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5639 CARDINAL RD, CAMPBELLTON, FL 32426-6902
(850) 814-5346
Mailing address
5639 CARDINAL RD, CAMPBELLTON, FL 32426-6902
(850) 814-5346
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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