Individual provider · Type 1 NPI
Dedra Matoya Robertson
Customized Equipment (DME) · Andalusia, AL
NPI number
1104388701
Active
Practice location
110 Beasley St
Andalusia, AL 36420-4957
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Customized Equipment (DME) Primary | 332BC3200X | 23190424 (AL) |
Customized Equipment (DME): Definition to come...
About NPI 1104388701
Dedra Matoya Robertson's National Provider Identifier is 1104388701, issued on Apr 2, 2019. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Andalusia, AL. The record was last updated on Apr 2, 2019.