Provider Demographics
NPI:1629383989
Name:ROBB, BRANDON DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DEAN
Last Name:ROBB
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 1:116 N ADAMSWOOD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-4004
Mailing Address - Country:US
Mailing Address - Phone:801-574-6752
Mailing Address - Fax:
Practice Address - Street 1:116 N ADAMSWOOD RD STE 1
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-4004
Practice Address - Country:US
Practice Address - Phone:801-574-6752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7722740-1202111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000000000030965OtherREGENCE OAID