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General NPI Number Information
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NPI Number | 1245391663
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Entity Type | Organization
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Legal Business Name | KNOBBS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 4305 BEVERLY STREET SUITE B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6623
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Country | US
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Telephone | 719-528-5656
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Fax | 719-528-6210
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Provider Business Mailing Address
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Address Line | 4305 BEVERLY STREET SUITE B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6623
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Country | US
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Telephone | 719-528-5656
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Fax | 719-528-6210
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JENAL MARIE BARKAS
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Credential | OFFICE MANAGER
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Telephone | 719-528-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3291
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License Number State | CO
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