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1154979557
BRANDEN M ROBERTS
LAKE CITY, IA
NPI
1154979557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: IA 082695)
Enumeration Date
2019-08-28
Last Update Date
2019-08-28
Business Address
BRANDEN M ROBERTS
1301 W MAIN ST
LAKE CITY, IA 51449-1585
Phone number: 712-464-3171
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Mailing Address
BRANDEN M ROBERTS
1301 W MAIN ST
LAKE CITY, IA 51449-1585
Phone number: 712-464-3171
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