Provider Demographics
NPI:1215240114
Name:ROBISON, NICHOLAS H (DC)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:H
Last Name:ROBISON
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 1:14108 RHONDA LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-7211
Mailing Address - Country:US
Mailing Address - Phone:404-788-9740
Mailing Address - Fax:
Practice Address - Street 1:14108 RHONDA LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-7211
Practice Address - Country:US
Practice Address - Phone:404-788-9740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010013341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor