Provider Demographics
NPI:1962585554
Name:ROBERSON, OLIVER CECIL (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:CECIL
Last Name:ROBERSON
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 1:1001 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 228
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5504
Mailing Address - Country:US
Mailing Address - Phone:202-293-8400
Mailing Address - Fax:202-293-8009
Practice Address - Street 1:1001 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 228
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5504
Practice Address - Country:US
Practice Address - Phone:202-293-8400
Practice Address - Fax:202-293-8009
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH30034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor