Provider Demographics
NPI:1083709307
Name:ROBBINS, MATTHEW DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DANIEL
Last Name:ROBBINS
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 1:1625 W INA RD STE 117
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1975
Mailing Address - Country:US
Mailing Address - Phone:520-690-1100
Mailing Address - Fax:520-690-1137
Practice Address - Street 1:1625 W INA RD STE 117
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-690-1100
Practice Address - Fax:520-690-1137
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ$$$$$$$$$OtherPTAN
AZZ$$$$$$$$$OtherPTAN