Provider Demographics
NPI:1972906071
Name:ROBSON, KATHRYN RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:RAE
Last Name:ROBSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6612 E 75TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2875
Mailing Address - Country:US
Mailing Address - Phone:317-288-5480
Mailing Address - Fax:317-288-5481
Practice Address - Street 1:6612 E 75TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2875
Practice Address - Country:US
Practice Address - Phone:317-288-5480
Practice Address - Fax:317-288-5481
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002804A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor