Provider Demographics
NPI:1881727089
Name:ROBSON, TODD ELLIS (DC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ELLIS
Last Name:ROBSON
Suffix:
Gender:M
Credentials:DC
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 36
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0036
Mailing Address - Country:US
Mailing Address - Phone:540-248-5711
Mailing Address - Fax:540-248-3744
Practice Address - Street 1:24 IDLEWOOD BLVD
Practice Address - Street 2:SUITE #102
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-9303
Practice Address - Country:US
Practice Address - Phone:540-248-5711
Practice Address - Fax:540-248-3744
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA172952OtherBC/BS
VAC09301Medicare PIN