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General NPI Number Information
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NPI Number | 1245498815
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Entity Type | Individual
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Provider Name | ROBINSON COVILLE
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Gender | Male
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 5633 N 350 E
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-7701
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Country | US
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Telephone | 260-691-1324
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Fax |
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Provider Business Mailing Address
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Address Line | 5633 N 350 E
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-7701
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32001122A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 06001687A
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License Number State | IN
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