Healthcare Provider Details

I. General information

NPI: 1306015169
Provider Name (Legal Business Name): ROBYN DAWN EGRY MT (ASCP)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBYN DAWN CIRCLE MT (ASCP)

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

1068 CORONADO PKWY S
THORNTON CO
80229-5470
US

V. Phone/Fax

Practice location:
  • Phone: 303-339-8020
  • Fax:
Mailing address:
  • Phone: 303-362-1709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License NumberMT 1947595
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: