Provider Demographics
NPI:1972174837
Name:KOBS, CHAD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:KOBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 COUNTY ROAD C
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:WI
Mailing Address - Zip Code:54025-7508
Mailing Address - Country:US
Mailing Address - Phone:651-269-7214
Mailing Address - Fax:
Practice Address - Street 1:1885 COUNTY ROAD C
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:WI
Practice Address - Zip Code:54025-7508
Practice Address - Country:US
Practice Address - Phone:651-269-7214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty