Individual
HEATHER ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2270 MEADOWLAKE RD APT 1007, CONWAY, AR 72032-2680
(870) 844-0516
Mailing address
2270 MEADOWLAKE RD APT 1007, CONWAY, AR 72032-2680
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14977
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456
NONE
—
Enumeration date
06/13/2019
Last updated
06/13/2019
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