Provider Demographics
NPI:1386658797
Name:BRAMBLE, TODD ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ANDREW
Last Name:BRAMBLE
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 1:110 RICHIE LN
Mailing Address - Street 2:STE. B
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-6128
Mailing Address - Country:US
Mailing Address - Phone:606-679-1433
Mailing Address - Fax:
Practice Address - Street 1:110 RICHIE LN
Practice Address - Street 2:STE. B
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6128
Practice Address - Country:US
Practice Address - Phone:606-679-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000156Medicaid
KY000000112945OtherANTHEM
KY85000156Medicaid
KY051504Medicare PIN