Provider Demographics
NPI:1164818571
Name:COBB CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:COBB CHIROPRACTIC, LLC
Other - Org Name:COBB CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-992-3221
Mailing Address - Street 1:412 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4107
Mailing Address - Country:US
Mailing Address - Phone:830-992-3221
Mailing Address - Fax:830-992-3212
Practice Address - Street 1:412 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4107
Practice Address - Country:US
Practice Address - Phone:830-992-3221
Practice Address - Fax:830-992-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty