Provider Demographics
NPI:1538310750
Name:COBB, STEPHEN C (PHD, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:C
Last Name:COBB
Suffix:
Gender:M
Credentials:PHD, ATC, CSCS
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Mailing Address - Street 1:PAVILION 350; ATEP
Mailing Address - Street 2:UNIVERSITY OF WISCONSIN MILWAUKEE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-0413
Mailing Address - Country:US
Mailing Address - Phone:414-229-3369
Mailing Address - Fax:414-229-3366
Practice Address - Street 1:PAVILION 350; ATEP
Practice Address - Street 2:UNIVERSITY OF WISCONSIN MILWAUKEE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-0413
Practice Address - Country:US
Practice Address - Phone:414-229-3369
Practice Address - Fax:414-229-3366
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI944-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer