Provider Demographics
NPI:1588924179
Name:ROBBINS, MARLYS HODD (LMT)
Entity type:Individual
Prefix:
First Name:MARLYS
Middle Name:HODD
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 GOLF VIEW DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9653
Mailing Address - Country:US
Mailing Address - Phone:541-613-5401
Mailing Address - Fax:
Practice Address - Street 1:737 GOLF VIEW DR
Practice Address - Street 2:SUITE B
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9661
Practice Address - Country:US
Practice Address - Phone:541-613-5401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17906225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist