Provider Information for 1447035365
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ROBERT ANSLEY ROOF IV MA LPC
Sex: Male
NPI: 1447035365
Last Updated: 2023-08-29
Certification Date: 2023-08-29
Certification Date: 2023-08-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1447035365 | ||||||||
| Enumeration Date | 2023-08-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 333 SILVERTON, CO 81433-0333 United States Phone: 970-749-5401 | Fax: | ||||||||
| Primary Practice Address | 1315 SNOWDEN ST SILVERTON, CO 81433-5108 United States Phone: 970-749-5401 | Fax: | ||||||||
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