Provider Demographics
NPI:1932163557
Name:STREBECK, BRINA KYLENE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:BRINA
Middle Name:KYLENE
Last Name:STREBECK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:975 OLD CORBIN PIKE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-2800
Mailing Address - Country:US
Mailing Address - Phone:606-261-4108
Mailing Address - Fax:606-539-4126
Practice Address - Street 1:7790 COLLEGE STATION DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1388
Practice Address - Country:US
Practice Address - Phone:606-539-4133
Practice Address - Fax:606-539-4126
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT5742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer