Provider Demographics
NPI:1255743597
Name:ROBINETT, BRYAN THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:THOMAS
Last Name:ROBINETT
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 1:355 CROSS ROADS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-2194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355 CROSS ROADS BLVD
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-2194
Practice Address - Country:US
Practice Address - Phone:859-908-0045
Practice Address - Fax:859-908-0046
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278458111N00000X
IL038012615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor