Provider Demographics
NPI:1447280029
Name:ROBISON, JAY CODY (MPT)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:CODY
Last Name:ROBISON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 LUDS WAY
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-9284
Mailing Address - Country:US
Mailing Address - Phone:530-532-8876
Mailing Address - Fax:
Practice Address - Street 1:9341 MIDWAY
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:CA
Practice Address - Zip Code:95938-9785
Practice Address - Country:US
Practice Address - Phone:530-343-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 24808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist