Provider Demographics
NPI:1962689349
Name:DOBSON, NICOLETTE MAE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLETTE
Middle Name:MAE
Last Name:DOBSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NICOLETTE
Other - Middle Name:MAE
Other - Last Name:SEARLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6860 STADIUM DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2004
Mailing Address - Country:US
Mailing Address - Phone:269-353-8800
Mailing Address - Fax:269-353-8855
Practice Address - Street 1:6860 STADIUM DR
Practice Address - Street 2:SUITE 103
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2004
Practice Address - Country:US
Practice Address - Phone:269-353-8800
Practice Address - Fax:269-353-8855
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor