NPI 1306558176

Detrick Robinson

Practitioner Driver Fort Wayne, IN

Practice location

Address: 3627 Plaza Dr, Fort Wayne, IN 46806-4346
Phone: (260) 557-0045

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1306558176
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Dec 2022
Record last updated: 29 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.