Organization
COOLBAUGH CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN E WALLACE (OFFICE MANAGER)
(806) 792-0026
Entity
Organization
Contact information
Practice address
5201 INDIANA AVE, STE 101, LUBBOCK, TX 79413-4213
(806) 792-4077
Mailing address
3502 156TH ST, LUBBOCK, TX 79423-6343
(806) 441-5555
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020711-01
—
TX
Enumeration date
03/30/2007
Last updated
08/08/2008
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