Provider Demographics
NPI:1336538560
Name:JOBE, MICHAEL JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:JOBE
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 1:3895 N WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1776
Mailing Address - Country:US
Mailing Address - Phone:765-288-8851
Mailing Address - Fax:765-288-8840
Practice Address - Street 1:3895 N WHEELING AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-1776
Practice Address - Country:US
Practice Address - Phone:765-288-8851
Practice Address - Fax:765-288-8840
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002821A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor