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NPI Code Detail

MEDICARE: JOEL B ROBB PT, ATC, SCS, CSCS

MEDICARE: JOEL B ROBB PT, ATC, SCS, CSCS
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
12251S0007XSports Physical Therapist6192
22255A2300XAthletic Trainer040402228
3225100000XPhysical TherapistPTL.0012140CO

General Provider Information

NPI Number : 1689668667
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL B ROBB PT, ATC, SCS, CSCS
Provider Business Mailing Address
First Line : 4102 PINION DR
Second Line :
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-3107
Fax Number :
Provider Business Practice Location Address
First Line : 4102 PINION DR
Second Line :
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-5942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 03/14/2018

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