Provider Demographics
NPI:1346397700
Name:ROBB, KIM R (DC)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:R
Last Name:ROBB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 HWY. 51
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558
Mailing Address - Country:US
Mailing Address - Phone:608-838-3600
Mailing Address - Fax:
Practice Address - Street 1:5708 HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:MCFARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558
Practice Address - Country:US
Practice Address - Phone:608-838-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38776800Medicaid
WI75-212Medicare ID - Type Unspecified