Provider Demographics
NPI:1770207656
Name:TRYBULL, BROOKELYNN DENISE (DC, MSFN, BS)
Entity type:Individual
Prefix:MRS
First Name:BROOKELYNN
Middle Name:DENISE
Last Name:TRYBULL
Suffix:
Gender:F
Credentials:DC, MSFN, BS
Other - Prefix:
Other - First Name:BROOKELYNN
Other - Middle Name:DENISE
Other - Last Name:MELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, MSFN, BS
Mailing Address - Street 1:5035 BROWN DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-6281
Mailing Address - Country:US
Mailing Address - Phone:435-630-0414
Mailing Address - Fax:
Practice Address - Street 1:112 W 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-5014
Practice Address - Country:US
Practice Address - Phone:940-648-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor