Provider Demographics
NPI:1013662253
Name:COMBS, DUSTIN LEE (DC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:LEE
Last Name:COMBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5900 CENTENNIAL CIR STE 180
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4249
Mailing Address - Country:US
Mailing Address - Phone:859-620-1325
Mailing Address - Fax:859-282-2027
Practice Address - Street 1:225 INDIAN MOUND DR
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1015
Practice Address - Country:US
Practice Address - Phone:859-587-9009
Practice Address - Fax:606-462-2025
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY275689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100800630Medicaid