Provider Demographics
NPI:1487162210
Name:LYDICK, ROBBYE (LMT)
Entity type:Individual
Prefix:
First Name:ROBBYE
Middle Name:
Last Name:LYDICK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:LYDICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:5710 S FOX ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2310
Mailing Address - Country:US
Mailing Address - Phone:720-207-4054
Mailing Address - Fax:
Practice Address - Street 1:899 N LOGAN ST STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3154
Practice Address - Country:US
Practice Address - Phone:720-295-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002526225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist