Provider Demographics
NPI:1336387497
Name:WESEN, ROBYN ALICIA (PT)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ALICIA
Last Name:WESEN
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 1:410 LUELLA ST
Mailing Address - Street 2:
Mailing Address - City:WATKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55389-1012
Mailing Address - Country:US
Mailing Address - Phone:320-764-2300
Mailing Address - Fax:
Practice Address - Street 1:600 S DAVIS AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-3431
Practice Address - Country:US
Practice Address - Phone:320-693-6228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist