Provider Demographics
NPI:1861721425
Name:COBB, MICHELE ERIN (DC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ERIN
Last Name:COBB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3965 PHELAN BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2231
Mailing Address - Country:US
Mailing Address - Phone:409-835-7676
Mailing Address - Fax:409-835-5106
Practice Address - Street 1:3965 PHELAN BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2231
Practice Address - Country:US
Practice Address - Phone:409-835-7676
Practice Address - Fax:409-835-5106
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor