Provider Demographics
NPI:1235423674
Name:ROBIDOUX, SUMMER B (DC)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:B
Last Name:ROBIDOUX
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 1:162 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2724
Mailing Address - Country:US
Mailing Address - Phone:970-481-2940
Mailing Address - Fax:
Practice Address - Street 1:162 E 29TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2724
Practice Address - Country:US
Practice Address - Phone:970-481-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5487111N00000X
NE1386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor