Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | KY4135 | KY |
N | 111NX0800X | Chiropractor Orthopedic Specialist | KY4135 | KY |
NPI | 1811043276 |
---|---|
Provider Name | Mr. Eric Leonard Ribenboim |
First Address | Shelbyville, KY 40065-1738 |
Second Address | Shelbyville, KY 40065-1738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 10/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1154468932 | GROUP NPI (01) | KY |
85000313 | (05) | KY |
X53335 | (02) | KY |