Healthcare Provider Details

I. General information

NPI: 1043557200
Provider Name (Legal Business Name): ROBIN ANNE DETMER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ROBIN ANNE DOTSON

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W 38TH AVE
EUGENE OR
97405-2375
US

IV. Provider business mailing address

805 W 38TH AVE
EUGENE OR
97405-2375
US

V. Phone/Fax

Practice location:
  • Phone: 541-654-7206
  • Fax:
Mailing address:
  • Phone: 541-654-7206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6316
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: