Individual
MYCKELL ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, NCSF-CPT
Contact information
Practice address
11144 AURORA AVE, URBANDALE, IA 50322-7903
(515) 278-6868
Mailing address
1200 NE EWING CT, GRIMES, IA 50111-1106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001504
IA
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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