Provider Demographics
NPI:1043557200
Name:DETMER, ROBIN ANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ANNE
Last Name:DETMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:ANNE
Other - Last Name:DOTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2375
Mailing Address - Country:US
Mailing Address - Phone:541-654-7206
Mailing Address - Fax:
Practice Address - Street 1:805 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2375
Practice Address - Country:US
Practice Address - Phone:541-654-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist