Provider Demographics
NPI:1225736531
Name:ROBINSON, JUSTIN K (PTA)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:K
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44688-0072
Mailing Address - Country:US
Mailing Address - Phone:419-481-3491
Mailing Address - Fax:
Practice Address - Street 1:44604 STERLING HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7962
Practice Address - Country:US
Practice Address - Phone:907-420-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK203491225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant