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General NPI Number Information
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NPI Number | 1609091982
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Entity Type | Individual
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Provider Name | JANICE EULA COATES O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4387 PARKWAY DR
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City | DAYTON
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State | OH
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Zip | 45416-1638
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Country | US
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Telephone | 937-278-7391
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Fax | 937-278-9418
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Provider Business Mailing Address
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Address Line | 4387 PARKWAY DR
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City | DAYTON
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State | OH
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Zip | 45416-1638
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Country | US
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Telephone | 937-278-7391
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Fax | 937-278-9418
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3450 T1613
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License Number State | OH
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