Provider Demographics
NPI:1770786956
Name:BRAD N. ROBINSON
Entity type:Organization
Organization Name:BRAD N. ROBINSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADBURY
Authorized Official - Middle Name:NORTON
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-588-8908
Mailing Address - Street 1:7400 GRANBY ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3436
Mailing Address - Country:US
Mailing Address - Phone:757-588-8908
Mailing Address - Fax:757-583-3069
Practice Address - Street 1:7400 GRANBY ST
Practice Address - Street 2:SUITE F
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3436
Practice Address - Country:US
Practice Address - Phone:757-588-8908
Practice Address - Fax:757-583-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA082175OtherBLUE CROSS BLUE SHIELD
VA788904OtherUNITED HEALTH CARE OPTIM
VA177083OtherBLUE CROSS BLUE SHIELD
VA082175OtherBLUE CROSS BLUE SHIELD