Provider Demographics
NPI:1265674774
Name:COBBS, PAMELA GWYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:GWYNNE
Last Name:COBBS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 SW CHANDLER AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3235
Mailing Address - Country:US
Mailing Address - Phone:541-389-0263
Mailing Address - Fax:541-389-0676
Practice Address - Street 1:1735 SW CHANDLER AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3235
Practice Address - Country:US
Practice Address - Phone:541-389-0263
Practice Address - Fax:541-389-0676
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor