Healthcare Provider Details

I. General information

NPI: 1982910972
Provider Name (Legal Business Name): PATRICIA COLEMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA COLEMAN SIGMON PT, DPT

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MILL ST NE STE E
VIENNA VA
22180-4500
US

IV. Provider business mailing address

1100 CIRCLE 75 PKWY SE SUITE 1400
ATLANTA GA
31193-0402
US

V. Phone/Fax

Practice location:
  • Phone: 703-991-8156
  • Fax: 703-991-8158
Mailing address:
  • Phone: 678-981-3543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305207844
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: