Individual
MRS. MAXINE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12647 OLIVE BLVD, SPECTRUM HEALTHCARE RESOURCES, ST. LOUIS, MO 63141
(757) 460-9862
Mailing address
1741 MEREDITH ROAD, VIRGINIA BEACH, VA 23455-3230
(757) 460-9862
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202010107
VA
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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