Provider Demographics
NPI:1326353186
Name:COBLER CHIROPRACTIC INC
Entity Type:Organization
Organization Name:COBLER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:COBLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:308-382-2222
Mailing Address - Street 1:2237 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1740
Mailing Address - Country:US
Mailing Address - Phone:308-382-2222
Mailing Address - Fax:308-382-9462
Practice Address - Street 1:2237 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1740
Practice Address - Country:US
Practice Address - Phone:308-382-2222
Practice Address - Fax:308-382-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025894100Medicaid
NENE # 1393OtherSTATE LICENSE
NE10025894100Medicaid