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NPI 1164252912

NPI 1164252912 : MICHELLE RENE ROBINSON PT : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1164252912
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    Entity Type          |    Individual 
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    Provider Name        |    MICHELLE RENE ROBINSON PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2024
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    Last Update Date     |    09/11/2024
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Provider Practice Location Address
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    Address Line         |    4311 HAINES ST APT 4 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92109-4307
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    Country              |    US
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    Telephone            |    209-484-6389
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4311 HAINES ST APT 4 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92109-4307
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    Country              |    US
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    Telephone            |    209-484-6389
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    306711
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    License Number State |    CA
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