Provider Demographics
NPI:1780675207
Name:RIVERS, ROBIN (LAT ATC)
Entity type:Individual
Prefix:MISS
First Name:ROBIN
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-0924
Mailing Address - Country:US
Mailing Address - Phone:316-650-9342
Mailing Address - Fax:
Practice Address - Street 1:2804 E 9TH AVE APT 33
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3312
Practice Address - Country:US
Practice Address - Phone:316-650-9342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24002672255A2300X
OH0001322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer