Doctor Name: | DR. MARC A ROBERTSON |
NPI Number: | 1003944505 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC, ATC, CSCS |
License Number: | 01-05089 |
Business Practice Address: | 1701 Madison Ave. Ste. A Derby, KS - 67037 |
Business Phone Number: | 3167883713 |
Business Fax Number: | 9138944427 |
Mailing Address: | 2301 Duckcreek Ln, DERBY |
State: | KS |
Postal Code: | 67037 |
Phone Number: | 8167868694 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 01-05089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |