Provider Demographics
NPI:1376655134
Name:CORBIN, BRADLEY S (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:S
Last Name:CORBIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:7111 S VIRGINIA ST
Mailing Address - Street 2:A 14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1115
Mailing Address - Country:US
Mailing Address - Phone:775-852-8000
Mailing Address - Fax:775-852-8008
Practice Address - Street 1:7111 S VIRGINIA ST
Practice Address - Street 2:A 14
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1115
Practice Address - Country:US
Practice Address - Phone:775-852-8000
Practice Address - Fax:775-852-8008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVB00216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV$$$$$$$$$Medicare PIN