Basic Information
Provider Information
NPI: 1255741443
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBSON
FirstName: ABIGAIL
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5718
Address2:  
City: KALISPELL
State: MT
PostalCode: 599035718
CountryCode: US
TelephoneNumber: 4067560134
FaxNumber: 4063001612
Practice Location
Address1: 2861 W 120TH AVE STE 120
Address2:  
City: WESTMINSTER
State: CO
PostalCode: 802342985
CountryCode: US
TelephoneNumber: 3034696980
FaxNumber: 3034696984
Other Information
ProviderEnumerationDate: 04/28/2014
LastUpdateDate: 07/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL.0016857COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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