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Individual

SETH B. COULTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
115 SKYLINE DR, SUITE A, RUSSELLVILLE, AR 72802-3310
(479) 967-5155
(479) 967-5141
Mailing address
115 SKLYLINE DRIVE STE A, RUSSELLVILLE, AR 72802-3310
(479) 967-5155
(479) 967-5141

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
624
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0489820001
DME MAC
AR
05
117393721
AR
Enumeration date
01/13/2006
Last updated
02/08/2008
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