Provider Demographics
NPI:1043933971
Name:CORBIN, KALLIE BROOKE (DC)
Entity type:Individual
Prefix:DR
First Name:KALLIE
Middle Name:BROOKE
Last Name:CORBIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 MILWAUKEE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0682
Mailing Address - Country:US
Mailing Address - Phone:806-319-5150
Mailing Address - Fax:
Practice Address - Street 1:6620 MILWAUKEE AVE STE 300
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0682
Practice Address - Country:US
Practice Address - Phone:806-319-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14981111N00000X
SC4758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty