Provider Demographics
NPI:1932258399
Name:ROBINSON CHIROPRACTIC, P.A
Entity Type:Organization
Organization Name:ROBINSON CHIROPRACTIC, P.A
Other - Org Name:BRENT JC ROBINSON, D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:JAMES CHARLES
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-487-5950
Mailing Address - Street 1:1752 LEXINGTON AVE N
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-6516
Mailing Address - Country:US
Mailing Address - Phone:651-487-5950
Mailing Address - Fax:651-487-6016
Practice Address - Street 1:1752 LEXINGTON AVE N
Practice Address - Street 2:SUITE B
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6516
Practice Address - Country:US
Practice Address - Phone:651-487-5950
Practice Address - Fax:651-487-6016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty