Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 4246 | AZ |
NPI | 1023390069 |
---|---|
Provider Name | Colleen Coakley |
First Address | Scottsdale, AZ 85251-2811 |
Second Address | Scottsdale, AZ 85251-5600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2011 |
Last Update Date | 20/09/2011 |