Provider Demographics
NPI:1205541232
Name:KING, ROBIN LEE (DOO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:KING
Suffix:
Gender:F
Credentials:DOO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 HILLS AND DALES RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1572
Mailing Address - Country:US
Mailing Address - Phone:330-209-4749
Mailing Address - Fax:
Practice Address - Street 1:4501 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1572
Practice Address - Country:US
Practice Address - Phone:330-209-4749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care