Provider Demographics
NPI:1407923071
Name:NOBBE, MARK G (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:G
Last Name:NOBBE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 S CHERRY ST STE 220
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1222
Mailing Address - Country:US
Mailing Address - Phone:303-996-9700
Mailing Address - Fax:303-996-9701
Practice Address - Street 1:469 S CHERRY ST STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1222
Practice Address - Country:US
Practice Address - Phone:303-996-9700
Practice Address - Fax:303-996-9701
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU57202Medicare UPIN
COC544338Medicare ID - Type Unspecified