Healthcare Provider Details

I. General information

NPI: 1104383710
Provider Name (Legal Business Name): CHRISTINA COBLISH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 03/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 ARAPAHOE AVE STE D
BOULDER CO
80303-1026
US

IV. Provider business mailing address

3216 ARAPAHOE AVE STE D
BOULDER CO
80303-1026
US

V. Phone/Fax

Practice location:
  • Phone: 303-900-7703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTINA COBLISH
Title or Position: PRESIDENT
Credential: DC
Phone: 303-900-7703