Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 588 | LA |
NPI | 1295759793 |
---|---|
Provider Name | Dr. David Kiplyn Corbin |
First Address | Baton Rouge, LA 70884-2808 |
Second Address | Baton Rouge, LA 70810-1078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |