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General NPI Number Information
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NPI Number | 1548687452
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Entity Type | Organization
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Legal Business Name | COLEMAN INSTITUTE RICHMOND, LLC
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 204 N HAMILTON ST SUITE B
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City | RICHMOND
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State | VA
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Zip | 23221-2662
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Country | US
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Telephone | 804-353-1230
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Fax | 804-353-3342
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Provider Business Mailing Address
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Address Line | 204 N HAMILTON ST SUITE B
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City | RICHMOND
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State | VA
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Zip | 23221-2662
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Country | US
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Telephone | 804-353-1230
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Fax | 804-353-3342
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER GIFFORD
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Credential |
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Telephone | 804-307-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101037152
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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