Provider Demographics
NPI:1457352973
Name:DOBROWOLSKI, ROBERT (DC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:DOBROWOLSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MOORE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-2987
Mailing Address - Country:US
Mailing Address - Phone:423-894-4771
Mailing Address - Fax:423-894-9332
Practice Address - Street 1:400 S MOORE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2987
Practice Address - Country:US
Practice Address - Phone:423-894-4771
Practice Address - Fax:423-894-9332
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
3676989Medicare ID - Type Unspecified
U46382Medicare UPIN