Provider Demographics
NPI:1225679608
Name:ROBINE, ROBERT JAMES JR (MAT, AT, ATC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:ROBINE
Suffix:JR
Gender:M
Credentials:MAT, AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 HETTENBERGER AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4968
Mailing Address - Country:US
Mailing Address - Phone:586-755-6102
Mailing Address - Fax:
Practice Address - Street 1:8405 HETTENBERGER AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4968
Practice Address - Country:US
Practice Address - Phone:586-755-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010025802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer