Provider Demographics
NPI:1699974022
Name:ROBIN LEE STROM PHYSICAL THERAPY
Entity type:Organization
Organization Name:ROBIN LEE STROM PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STROM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-634-9261
Mailing Address - Street 1:PO BOX 3635
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2561
Mailing Address - Country:US
Mailing Address - Phone:928-634-9261
Mailing Address - Fax:928-639-0167
Practice Address - Street 1:3060 W HWY 89A
Practice Address - Street 2:STE B
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5035
Practice Address - Country:US
Practice Address - Phone:928-634-9261
Practice Address - Fax:928-639-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2387208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS88252Medicare UPIN
AZZ29043Medicare PIN