Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 204C00000X | AZ |
NPI | 1992269997 |
---|---|
Provider Name | Ms. Robyn E See |
First Address | Peoria, AZ 85383-5612 |
Second Address | Surprise, AZ 85374-7464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2019 |
Last Update Date | 24/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000234346 | BOARD OF CERTIFICATION-CERTIFIED ATHLETIC TRAINER (01) | KS |