Provider Demographics
NPI:1841366077
Name:COBB, KARI (LAC, DACM)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 WESTERN AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3880
Mailing Address - Country:US
Mailing Address - Phone:920-602-7915
Mailing Address - Fax:920-273-3776
Practice Address - Street 1:885 WESTERN AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3874
Practice Address - Country:US
Practice Address - Phone:920-602-7915
Practice Address - Fax:920-273-3776
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI401-55171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist