MEDICARE: MRS. RAINA L ROBINSON DC

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	111N00000X	Chiropractor	X0093541	NY

General Provider Information

NPI Number	:	1396850590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RAINA L ROBINSON DC

Provider Business Mailing Address
First Line	:	PO BOX 126
Second Line	:	11444 STATE ROUTE 12
City	:	ALDER CREEK
State	:	NY
Zip	:	13301
Country	:	US
Telephone Number	:	315-831-3913
Fax Number	:

Provider Business Practice Location Address
First Line	:	11444 ST. RT. 12
Second Line	:
City	:	ALDER CREEK
State	:	NY
Zip	:	13301-0126
Country	:	US
Telephone Number	:	315-831-3913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	10/07/2010

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