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General NPI Number Information
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NPI Number | 1548289978
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Entity Type | Individual
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Provider Name | ROBERT T. IRWIN DC
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 08/20/2016
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Provider Practice Location Address
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Address Line | 204 DELAWARE AVE DELMAR CHIROPRACTIC
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City | DELMAR
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State | NY
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Zip | 12054-1227
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Country | US
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Telephone | 518-439-7644
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Fax | 518-439-0191
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Provider Business Mailing Address
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Address Line | 204 DELAWARE AVE. DELMAR CHIROPRACTIC
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City | DELMAR
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State | NY
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Zip | 12054
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Country | US
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Telephone | 518-439-7644
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Fax | 518-439-0191
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X009338-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | X012138-1
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License Number State | NY
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