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General NPI Number Information
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NPI Number | 1699221283
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Entity Type | Individual
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Provider Name | RYAN LOYD ROBINSON ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 5671 PEACHTREE DUNWOODY RD STE 900
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 678-464-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 40 PEACHTREE VALLEY RD NE APT 2315
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City | ATLANTA
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State | GA
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Zip | 30309-8011
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT002529
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License Number State | GA
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