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1104388701
DEDRA MATOYA ROBERTSON
ANDALUSIA, AL
NPI
1104388701
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment
(Licence: AL 23190424)
Enumeration Date
2019-04-02
Last Update Date
2019-04-02
Business Address
DEDRA MATOYA ROBERTSON
110 BEASLEY ST
ANDALUSIA, AL 36420-4957
Phone number: 334-892-3784
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Mailing Address
DEDRA MATOYA ROBERTSON
110 BEASLEY ST
ANDALUSIA, AL 36420-4957
Phone number: 334-892-3784
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