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Individual

DR. MARK RICHARD COBLEIGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
10403 S 15TH ST, SUITE 102, BELLEVUE, NE 68123-4448
(402) 734-6711
(402) 734-4162
Mailing address
10403 S 15TH ST, SUITE 102, BELLEVUE, NE 68123-4448
(402) 734-6711
(402) 734-4162

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
633
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09618
BLUE CROSS BLUE SHIELD
NE
05
0991463
IA
05
4480052
NE
01
4561145
MIDLANDS CHOICE
NE
05
470613526-13
NE
Enumeration date
10/24/2006
Last updated
09/13/2011
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