Individual
DAVID E COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3806 AMELIA AVE, LAFAYETTE, IN 47905-5772
(765) 807-2773
(765) 807-2774
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002669A
IN
2251S0007X
Sports Physical Therapist
05002669A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000496786
ANTHEM
IN
05
—
201164480
—
IN
Enumeration date
10/16/2006
Last updated
02/13/2024
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