Provider Demographics
NPI:1992918395
Name:MOBUS, RICHARD KEITH (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KEITH
Last Name:MOBUS
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 1:1970 S OGDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4133
Mailing Address - Country:US
Mailing Address - Phone:720-570-8664
Mailing Address - Fax:303-871-0218
Practice Address - Street 1:1212 S BROADWAY STE 150
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1583
Practice Address - Country:US
Practice Address - Phone:303-777-2777
Practice Address - Fax:303-871-0218
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3399111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health