Provider Demographics
NPI:1053657239
Name:DOERMER, ROBBIN R (DC)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:R
Last Name:DOERMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1439
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63022-1439
Mailing Address - Country:US
Mailing Address - Phone:636-236-9790
Mailing Address - Fax:
Practice Address - Street 1:161 AULD SPANISH CT
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-3711
Practice Address - Country:US
Practice Address - Phone:636-236-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012034524111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor