Healthcare Provider Details

I. General information

NPI: 1013575489
Provider Name (Legal Business Name): HEATHER ROBBINS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2019
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SMITH AVE N
SAINT PAUL MN
55102-2344
US

IV. Provider business mailing address

19911 FARNHAM RD N
FOREST LAKE MN
55025-2722
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-8290
  • Fax:
Mailing address:
  • Phone: 651-285-0735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number8118
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: