Healthcare Provider Details

I. General information

NPI: 1255255451
Provider Name (Legal Business Name): SHELETHIA COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4434 SECOR RD STE 2
TOLEDO OH
43623-4265
US

IV. Provider business mailing address

4434 SECOR RD STE 2
TOLEDO OH
43623-4265
US

V. Phone/Fax

Practice location:
  • Phone: 844-793-8787
  • Fax:
Mailing address:
  • Phone: 844-793-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.027200
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: