MEDICARE: DR. DANYELL COBB DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH60104625	WA

General Provider Information

NPI Number	:	1972736833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANYELL COBB DC

Provider Business Mailing Address
First Line	:	20218 77TH AVE NE STE A
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-4602
Country	:	US
Telephone Number	:	360-435-3900
Fax Number	:	360-435-1105

Provider Business Practice Location Address
First Line	:	20218 77TH AVE NE STE A
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-4602
Country	:	US
Telephone Number	:	360-435-3900
Fax Number	:	360-435-1105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2009
Last Update Date	:	08/26/2009

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