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NPI Code Detail

MEDICARE: MRS. ROBIN LYNN KRASSOW PTA

MEDICARE:  MRS. ROBIN LYNN KRASSOW  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant06001969AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200675870AOTHERINFIRST STEPS

General Provider Information

NPI Number : 1013182948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROBIN LYNN KRASSOW PTA
Provider Business Mailing Address
First Line : 2809 GREENWOOD AVE
Second Line :
City : TRAIL CREEK
State : IN
Zip : 46360-5709
Country : US
Telephone Number : 219-898-5822
Fax Number : 219-861-0292
Provider Business Practice Location Address
First Line : 2809 GREENWOOD AVE
Second Line :
City : TRAIL CREEK
State : IN
Zip : 46360-5709
Country : US
Telephone Number : 219-898-5822
Fax Number : 219-861-0292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2008
Last Update Date : 04/22/2008

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Directions to “ MRS. ROBIN LYNN KRASSOW PTA” Practice Location

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