Individual
MR. MARK ROBERT ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
324 ROXBURY RD, ROCKFORD, IL 61107-5090
(815) 398-9491
(815) 381-7489
Mailing address
2722 BROADMOOR DR, ROCKFORD, IL 61108-1620
(815) 757-0405
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002786
IL
Other
Enumeration date
07/08/2009
Last updated
07/08/2009
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