Healthcare Provider Details

I. General information

NPI: 1932258399
Provider Name (Legal Business Name): ROBINSON CHIROPRACTIC, P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 LEXINGTON AVE N SUITE B
ROSEVILLE MN
55113-6516
US

IV. Provider business mailing address

1752 LEXINGTON AVE N SUITE B
ROSEVILLE MN
55113-6516
US

V. Phone/Fax

Practice location:
  • Phone: 651-487-5950
  • Fax: 651-487-6016
Mailing address:
  • Phone: 651-487-5950
  • Fax: 651-487-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4085
License Number StateMN

VIII. Authorized Official

Name: DR. BRENT JAMES CHARLES ROBINSON
Title or Position: CEO
Credential: D.C.
Phone: 651-487-5950