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General NPI Number Information
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NPI Number | 1083121198
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Entity Type | Individual
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Provider Name | CRAIG ALLEN COATS ATC/L, CA
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Gender | Male
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 2625 E CACTUS RD
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City | PHOENIX
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State | AZ
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Zip | 85032-7042
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Country | US
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Telephone | 602-919-0486
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Fax |
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Provider Business Mailing Address
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Address Line | 14096 W BANFF LN
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City | SURPRISE
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State | AZ
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Zip | 85379-8608
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Country | US
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Telephone | 480-734-6995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0496
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License Number State | AZ
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