Provider Demographics
NPI:1083600373
Name:ROBINSON, RYAN SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SCOTT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191A W PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6806
Mailing Address - Country:US
Mailing Address - Phone:704-664-4000
Mailing Address - Fax:704-660-5251
Practice Address - Street 1:191A W PLAZA DR
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6806
Practice Address - Country:US
Practice Address - Phone:704-664-4000
Practice Address - Fax:704-660-5251
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890849TMedicaid
NC2454136BMedicare ID - Type Unspecified