Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC6054 | TX |
NPI | 1154446805 |
---|---|
Provider Name | Dr. Joseph Scott Coleman |
First Address | Dallas, TX 75235-7448 |
Second Address | Dallas, TX 75235-7448 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |