Provider Demographics
NPI:1396783817
Name:ROBINSON, RACHELLE JO STIDD (DC)
Entity type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:JO STIDD
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:JO
Other - Last Name:STIDD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:215-321-6555
Mailing Address - Fax:215-321-6533
Practice Address - Street 1:76 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-321-6555
Practice Address - Fax:215-321-6533
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADCOO9542111N00000X
PADC009542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor