Provider Demographics
NPI:1366081689
Name:BRINK, COLBY DION (DC)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:DION
Last Name:BRINK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 W CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6805
Mailing Address - Country:US
Mailing Address - Phone:866-682-4842
Mailing Address - Fax:877-436-1488
Practice Address - Street 1:13161 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LE GRAND
Practice Address - State:CA
Practice Address - Zip Code:95333-9766
Practice Address - Country:US
Practice Address - Phone:866-682-4842
Practice Address - Fax:877-436-1488
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor