Healthcare Provider Details

I. General information

NPI: 1497959019
Provider Name (Legal Business Name): VICKY N. ROBBINS R.R.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4885 S 900 E STE 107
SALT LAKE CITY UT
84117-3905
US

IV. Provider business mailing address

2912 SAINT MARYS WAY
SALT LAKE CITY UT
84108-2044
US

V. Phone/Fax

Practice location:
  • Phone: 801-266-0399
  • Fax:
Mailing address:
  • Phone: 801-582-4391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number112389-5701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: