Provider Demographics
NPI:1902901721
Name:BIBY, DAVID G (DC CCSP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:BIBY
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29145 E US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-9620
Mailing Address - Country:US
Mailing Address - Phone:719-948-2606
Mailing Address - Fax:719-948-2620
Practice Address - Street 1:29145 E US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81006-9620
Practice Address - Country:US
Practice Address - Phone:719-948-2606
Practice Address - Fax:719-948-2620
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COM11068OtherWORKERS COMP.
COC22783Medicare PIN