Provider Demographics
NPI:1134168297
Name:COBLE, JON JASON (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:JASON
Last Name:COBLE
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:PO BOX 3238
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-3238
Mailing Address - Country:US
Mailing Address - Phone:254-897-7447
Mailing Address - Fax:254-897-2099
Practice Address - Street 1:507C SW BIG BEND TRL
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-4425
Practice Address - Country:US
Practice Address - Phone:245-897-7447
Practice Address - Fax:254-897-2099
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX9223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor