Healthcare Provider Details

I. General information

NPI: 1396723615
Provider Name (Legal Business Name): CHARLES C ROBINSON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 WAZEE ST UNIT D
DENVER CO
80202-1478
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-534-9553
  • Fax: 720-932-8815
Mailing address:
  • Phone: 303-534-9553
  • Fax: 720-932-8815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7992
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: