MEDICARE: MRS. VICKY N. ROBBINS R.R.T.

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	2279P1005X	Pulmonary Rehabilitation Registered Respiratory Therapist	112389-5701	UT

General Provider Information

NPI Number	:	1497959019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICKY N. ROBBINS R.R.T.

Provider Business Mailing Address
First Line	:	2912 SAINT MARYS WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2044
Country	:	US
Telephone Number	:	801-582-4391
Fax Number	:

Provider Business Practice Location Address
First Line	:	4885 S 900 E STE 107
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3905
Country	:	US
Telephone Number	:	801-266-0399
Fax Number	:

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

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	07/08/2007

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