Provider Demographics
NPI:1518955475
Name:WITT, ROBIN R (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:R
Last Name:WITT
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 1:3004 HIGHWAY 121 STE A
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4088
Mailing Address - Country:US
Mailing Address - Phone:817-283-4088
Mailing Address - Fax:817-571-9756
Practice Address - Street 1:3004 STATE HWY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-283-4088
Practice Address - Fax:817-571-9756
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4861111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician