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1073084984
STACEY A ROUMILLAT
FREDERICKSBURG, VA
NPI
1073084984
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Former Name
STACEY WALDRON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110006581)
Enumeration Date
2018-12-17
Last Update Date
2022-12-01
Business Address
STACEY A ROUMILLAT pa
3310 FALL HILL AVE
FREDERICKSBURG, VA 22401-3000
Phone number: 540-373-4602
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Mailing Address
STACEY A ROUMILLAT pa
2300 FALL HILL AVE STE 317
FREDERICKSBURG, VA 22401-3343
Phone number: 407-414-2575
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