Individual
DEMARCO ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3716 MARIGOLD DR, FORT WAYNE, IN 46815-5922
(734) 672-0525
Mailing address
3716 MARIGOLD DR, FORT WAYNE, IN 46815-5922
(734) 672-0525
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
172A00000X
Driver
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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