Provider Demographics
NPI:1740940188
Name:ROBINSON, DANIEL L
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MARKET ST # 619
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26147-4700
Mailing Address - Country:US
Mailing Address - Phone:304-354-7017
Mailing Address - Fax:
Practice Address - Street 1:105 MARKET ST # 619
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26147-4700
Practice Address - Country:US
Practice Address - Phone:304-354-7017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant