Basic Information
Provider Information
NPI: 1740492065
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LITTLE
FirstName: ROBIN
MiddleName: D
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: 510 W 25TH ST
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283583522
CountryCode: US
TelephoneNumber: 9107350864
FaxNumber:  
Practice Location
Address1: 300 WEST 27TH STREET
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283583075
CountryCode: US
TelephoneNumber: 9106715000
FaxNumber: 9106715118
Other Information
ProviderEnumerationDate: 05/07/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X2542NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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