Provider Demographics
NPI:1821155193
Name:STROM, ROBIN LEE (PT)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LEE
Last Name:STROM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 S ACOMA DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5153
Mailing Address - Country:US
Mailing Address - Phone:928-634-9261
Mailing Address - Fax:
Practice Address - Street 1:3060 W HIGHWAY 89A
Practice Address - Street 2:SUITE B
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5035
Practice Address - Country:US
Practice Address - Phone:928-634-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ29043Medicare ID - Type Unspecified
S88252Medicare UPIN