Provider Demographics
NPI:1538222567
Name:WYZINSKI, ROBYN (PT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:WYZINSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S BROADWAY
Mailing Address - Street 2:APARTMENT #117
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-1668
Mailing Address - Country:US
Mailing Address - Phone:630-664-3445
Mailing Address - Fax:630-994-5023
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:630-664-3445
Practice Address - Fax:630-994-5023
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-0125442251P0200X
CA40054225100000X
CO0013651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics