Provider Demographics
NPI:1023062486
Name:KOBBE, MICHELLE (DC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:KOBBE
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 1:488 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7328
Mailing Address - Country:US
Mailing Address - Phone:631-549-5437
Mailing Address - Fax:631-385-8484
Practice Address - Street 1:488 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7328
Practice Address - Country:US
Practice Address - Phone:631-549-5437
Practice Address - Fax:631-385-8484
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011109-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor