Provider Demographics
NPI:1104862853
Name:ROBBINS, BRIAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 PINEY FOREST RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4154
Mailing Address - Country:US
Mailing Address - Phone:434-793-0700
Mailing Address - Fax:434-793-9315
Practice Address - Street 1:441 PINEY FOREST RD
Practice Address - Street 2:SUITE G
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4154
Practice Address - Country:US
Practice Address - Phone:434-793-0700
Practice Address - Fax:434-793-9315
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000300225Medicaid
C05545OtherPTAN
C05545OtherPTAN
VA000300225Medicaid
350000848Medicare PIN