=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033028824
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COILISTRY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2026
-----------------------------------------------------
Last Update Date | 09/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3465 DULUTH HIGHWAY 120 APT 5226
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-3448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-206-5764
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3465 DULUTH HIGHWAY 120 APT 5226
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-3448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-206-5764
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CARNIYAH DUNN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-255-0339
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------