Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT17119 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT17119 | CA |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT17119 | CA |
NPI | 1265730188 |
---|---|
Provider Name | Colette M. Coiner |
First Address | San Diego, CA 92130-3320 |
Second Address | San Diego, CA 92130-2035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2011 |
Last Update Date | 20/02/2020 |