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NPI Code Detail

MEDICARE: KIMBERLY J COLEMAN DPT

MEDICARE: KIMBERLY J COLEMAN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00010458WA

General Provider Information

NPI Number : 1164628459
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY J COLEMAN DPT
Provider Business Mailing Address
First Line : 1202 N PEARL ST
Second Line : APT K103
City : TACOMA
State : WA
Zip : 98406-7900
Country : US
Telephone Number : 425-785-1367
Fax Number :
Provider Business Practice Location Address
First Line : 19820 STATE ROUTE 410 E
Second Line : SUITE 201
City : BONNEY LAKE
State : WA
Zip : 98391-6377
Country : US
Telephone Number : 253-863-7510
Fax Number : 253-863-5970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY J COLEMAN DPT” Practice Location

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