Provider Demographics
NPI:1265637813
Name:COBB, PAULA ANN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:COBB
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 329
Mailing Address - Street 2:119 MAIN STREET
Mailing Address - City:CARBONDALE
Mailing Address - State:KS
Mailing Address - Zip Code:66414
Mailing Address - Country:US
Mailing Address - Phone:785-836-7500
Mailing Address - Fax:785-836-7500
Practice Address - Street 1:119 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:KS
Practice Address - Zip Code:66414-9628
Practice Address - Country:US
Practice Address - Phone:785-836-7500
Practice Address - Fax:785-836-7500
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist