Provider Demographics
NPI:1235171927
Name:KOBYLINSKI, CASIMER I (D C)
Entity Type:Individual
Prefix:
First Name:CASIMER
Middle Name:
Last Name:KOBYLINSKI
Suffix:I
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3350
Mailing Address - Country:US
Mailing Address - Phone:920-458-2225
Mailing Address - Fax:
Practice Address - Street 1:934 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3350
Practice Address - Country:US
Practice Address - Phone:920-458-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2190111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI070951Medicare ID - Type Unspecified