Provider Demographics
NPI:1063511905
Name:IRWIN, ROBIN D (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:D
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 6TH AVE SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3907
Mailing Address - Country:US
Mailing Address - Phone:256-309-0454
Mailing Address - Fax:256-309-0422
Practice Address - Street 1:922 6TH AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3907
Practice Address - Country:US
Practice Address - Phone:256-309-0454
Practice Address - Fax:256-309-0422
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51075088OtherBCBS
AL890013170Medicaid