Provider Demographics
NPI:1972190809
Name:HARR, ROBIN LYNN (ATC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:HARR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 ULMER LN
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-3158
Mailing Address - Country:US
Mailing Address - Phone:334-372-3866
Mailing Address - Fax:
Practice Address - Street 1:1 BUCCANEER DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-8940
Practice Address - Country:US
Practice Address - Phone:334-372-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-26
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL54322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer