Provider Demographics
NPI:1134569676
Name:ROBERT B. CONKLE, D.C, INC.
Entity type:Organization
Organization Name:ROBERT B. CONKLE, D.C, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:CONKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-423-4700
Mailing Address - Street 1:1206 LIMA AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1426
Mailing Address - Country:US
Mailing Address - Phone:419-423-4700
Mailing Address - Fax:419-423-6693
Practice Address - Street 1:1206 LIMA AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1426
Practice Address - Country:US
Practice Address - Phone:419-423-4700
Practice Address - Fax:419-423-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0609021Medicare PIN
T48171Medicare UPIN