Provider Demographics
NPI:1306929682
Name:COBURN, SYBIL ANN (DC)
Entity type:Individual
Prefix:DR
First Name:SYBIL
Middle Name:ANN
Last Name:COBURN
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:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:FREEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13068-0113
Mailing Address - Country:US
Mailing Address - Phone:607-844-3304
Mailing Address - Fax:607-844-9654
Practice Address - Street 1:15 ADAMS ST
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-1601
Practice Address - Country:US
Practice Address - Phone:315-246-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor