Provider Demographics
NPI:1356494009
Name:ELDRIDGE, ROBIN DENISE (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DENISE
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 APPLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-4824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3805 CUTSHAW AVE
Practice Address - Street 2:DANIEL BUILDING SUITE 299
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3943
Practice Address - Country:US
Practice Address - Phone:804-340-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260000882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer