Provider Demographics
NPI:1245391663
Name:KNOBBS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KNOBBS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENAL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARKAS
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:719-528-5656
Mailing Address - Street 1:4305 BEVERLY STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6623
Mailing Address - Country:US
Mailing Address - Phone:719-528-5656
Mailing Address - Fax:719-528-6210
Practice Address - Street 1:4305 BEVERLY STREET
Practice Address - Street 2:SUITE B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6623
Practice Address - Country:US
Practice Address - Phone:719-528-5656
Practice Address - Fax:719-528-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC428708Medicare PIN