Provider Demographics
NPI:1922050376
Name:ROBINSON, JACOB GENE (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:GENE
Last Name:ROBINSON
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 1:4500 ARROWHEAD RIDGE DR SE STE 102
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-5986
Mailing Address - Country:US
Mailing Address - Phone:505-867-1122
Mailing Address - Fax:866-929-7166
Practice Address - Street 1:4500 ARROWHEAD RIDGE DR SE STE 102
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-5986
Practice Address - Country:US
Practice Address - Phone:505-867-1122
Practice Address - Fax:866-929-7166
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor