Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 5151014449APP20 | MI |
NPI | 1285257824 |
---|---|
Provider Name | Amanda Leigh Robinson |
First Address | Dothan, AL 36303-4003 |
Second Address | East Lansing, MI 48823-6804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2020 |
Last Update Date | 18/05/2020 |