Provider Demographics
NPI:1225464977
Name:RIVERS, ROBIN KATHLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:KATHLEEN
Last Name:RIVERS
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 1:418 TRACE WAY DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-6852
Mailing Address - Country:US
Mailing Address - Phone:936-207-9111
Mailing Address - Fax:936-588-0854
Practice Address - Street 1:418 TRACE WAY DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-6852
Practice Address - Country:US
Practice Address - Phone:936-207-9111
Practice Address - Fax:936-588-0854
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor