Provider Demographics
NPI:1225038474
Name:ROBBINS, STEVEN E (MSPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12198 S STATE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9647
Mailing Address - Country:US
Mailing Address - Phone:801-571-6600
Mailing Address - Fax:801-571-7646
Practice Address - Street 1:12198 S STATE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9647
Practice Address - Country:US
Practice Address - Phone:801-571-6600
Practice Address - Fax:801-571-7646
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT54014502401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT183715OtherPEHP
UTU000096433Medicare UPIN
UTD5373/870578539003Medicaid
64-00669OtherUNITED HEALTHCARE PIN
UTQM0000076331OtherALTIUS PROVIDER ID
UT54014502400001OtherBCBS PROVIDER ID#