Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS7343 | TN |
NPI | 1043360811 |
---|---|
Provider Name | Dr. Christopher Alan Coleman |
First Address | Chattanooga, TN 37421-6784 |
Second Address | Chattanooga, TN 37421-6784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |