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General NPI Number Information
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NPI Number | 1215341375
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Entity Type | Organization
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Legal Business Name | ROBIN ALVERSON INC
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 33 UPPER RIVERDALE RD SW STE 117
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City | RIVERDALE
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State | GA
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Zip | 30274-2642
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Country | US
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Telephone | 770-991-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 110 HILLCREST PT
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City | FAYETTEVILLE
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State | GA
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Zip | 30215-2394
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Country | US
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Telephone | 770-991-1170
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Fax | 770-991-0107
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN ALVERSON
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Credential |
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Telephone | 770-991-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD000854
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License Number State | GA
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