Provider Demographics
NPI:1356011951
Name:ROBISON, ALVIN BENJAMIN (MOT, OTR)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:BENJAMIN
Last Name:ROBISON
Suffix:
Gender:M
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 W 1550 N STE H
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2279
Mailing Address - Country:US
Mailing Address - Phone:801-618-7903
Mailing Address - Fax:
Practice Address - Street 1:365 W 1550 N
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-6888
Practice Address - Country:US
Practice Address - Phone:801-618-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist