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Dedra Matoya Robertson
Customized Equipment (DME) in Andalusia, Alabama
NPI 1104388701

Dedra Matoya Robertson is a Customized Equipment (DME) based in Andalusia, AL and is specialized in Customized Equipment. Dedra Matoya Robertson practices in Andalusia, AL. The NPI Number for Dedra Matoya Robertson is 1104388701 and holds a License No. 23190424 (Alabama).

The current practice location address for Dedra Matoya Robertson is 110 Beasley St, Andalusia, AL and can be reached out via phone at 334-892-3784.

Location: 110 Beasley St, Andalusia, AL, 36420-4957
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104388701
Provider Name
Dedra Matoya Robertson
Credential
Provider Entity Type
Individual
Gender
Female
Address
110 Beasley St, Andalusia, AL, 36420-4957
Phone Number
334-892-3784
Fax Number
Provider Enumeration Date
04/02/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Beasley St
City
Andalusia
State
Alabama
Zip
36420-4957
Phone Number
334-892-3784
Fax Number
person
Provider Business Mailing Address Details
Address
110 Beasley St
City
Andalusia
State
Alabama
Zip
36420-4957
Phone Number
334-892-3784
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
23190424 (Alabama)
Definition
Definition to come...
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