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NPI Code Detail

MEDICARE: GARY ANTHONY COLEMAN PT

MEDICARE:   GARY ANTHONY COLEMAN  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT14720CA

General Provider Information

NPI Number : 1932184702
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY ANTHONY COLEMAN PT
Provider Business Mailing Address
First Line : 29650 BRADLEY RD
Second Line :
City : MENIFEE
State : CA
Zip : 92586-6521
Country : US
Telephone Number : 951-672-0455
Fax Number : 951-672-0206
Provider Business Practice Location Address
First Line : 29650 BRADLEY RD
Second Line :
City : MENIFEE
State : CA
Zip : 92586-6521
Country : US
Telephone Number : 951-672-0455
Fax Number : 951-672-0206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 11/02/2010

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Directions to “ GARY ANTHONY COLEMAN PT” Practice Location

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