MEDICARE: ROBIN ALVERSON INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AUD000854	GA

General Provider Information

NPI Number	:	1215341375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBIN ALVERSON INC

Provider Business Mailing Address
First Line	:	110 HILLCREST PT
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30215-2394
Country	:	US
Telephone Number	:	770-991-1170
Fax Number	:	770-991-0107

Provider Business Practice Location Address
First Line	:	33 UPPER RIVERDALE RD SW
Second Line	:	STE 117
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2642
Country	:	US
Telephone Number	:	770-991-1170
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN ALVERSON
Credential	:
Telephone Number	:	770-991-1170

Provider Enumeration Date	:	06/17/2014
Last Update Date	:	06/17/2014

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Directions to “ROBIN ALVERSON INC ” Practice Location

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