Provider Demographics
NPI:1598011892
Name:ANDERSON, ROBIN LEE (DC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LEE
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5701 UTICA RIDGE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2914
Mailing Address - Country:US
Mailing Address - Phone:563-344-8644
Mailing Address - Fax:888-893-9886
Practice Address - Street 1:5701 UTICA RIDGE RD
Practice Address - Street 2:STE 200
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2914
Practice Address - Country:US
Practice Address - Phone:563-344-8644
Practice Address - Fax:888-893-9886
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA007555OtherLICENSE