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General NPI Number Information
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NPI Number | 1639340110
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Entity Type | Organization
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Legal Business Name | ROBERT J. COOLBAUGH, DC, DBA LUBBOCK ACCIDENT AND INJURY REHAB
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 2318 50TH ST
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City | LUBBOCK
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State | TX
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Zip | 79412-2502
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Country | US
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Telephone | 806-780-1258
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Fax | 806-780-1261
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Provider Business Mailing Address
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Address Line | 2318 50TH ST
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City | LUBBOCK
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State | TX
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Zip | 79412-2502
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Country | US
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Telephone | 806-780-1258
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT J COOLBAUGH
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Credential | DC
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Telephone | 806-780-1258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | F008104
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License Number State | TX
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