MEDICARE: DR. LYDIE COLEMAN D.C.

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
1	111N00000X	Chiropractor	MA2710	MA

General Provider Information

NPI Number	:	1457344848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYDIE COLEMAN D.C.

Provider Business Mailing Address
First Line	:	13 HIGHLAND CIR STE E
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3031
Country	:	US
Telephone Number	:	781-455-0040
Fax Number	:	781-455-7999

Provider Business Practice Location Address
First Line	:	13 HIGHLAND CIR STE E
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3031
Country	:	US
Telephone Number	:	781-455-0040
Fax Number	:	781-455-7999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	10/14/2019

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