Provider Demographics
NPI:1689871436
Name:COBBLE, DANIEL DA'MON (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DA'MON
Last Name:COBBLE
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 KILBRANNON DR
Mailing Address - Street 2:APT. A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-5144
Mailing Address - Country:US
Mailing Address - Phone:803-740-5207
Mailing Address - Fax:
Practice Address - Street 1:34 KILBRANNON DR
Practice Address - Street 2:APT. A
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5144
Practice Address - Country:US
Practice Address - Phone:803-740-5207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer