Provider Demographics
NPI:1427752922
Name:ROBISON, ISABEAU AURELIA
Entity type:Individual
Prefix:
First Name:ISABEAU
Middle Name:AURELIA
Last Name:ROBISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ISABEAU
Other - Middle Name:AURELIA
Other - Last Name:VAN SOOLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3122 S BUENA VERDE LN
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-2755
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:220 MILLPOND STE 109
Practice Address - Street 2:
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-9760
Practice Address - Country:US
Practice Address - Phone:435-882-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist