Individual
DR. JACK COATES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
229 5TH ST, ELYRIA, OH 44035-5721
(440) 322-9096
(440) 322-6710
Mailing address
229 5TH ST, ELYRIA, OH 44035-5721
(440) 322-9096
(440) 322-6710
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
757
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000129647
ANTHEM BC/BS
OH
05
—
0405761
—
OH
01
—
1005721
ASHN
OH
01
—
10789858
CAQH
OH
01
—
341293302001
MEDICAL MUTUAL
OH
01
—
341293302003
MEDICAL MUTUAL
OH
01
—
34129330201
WORKER'S COMP
OH
01
—
341293302026
CARESOURCE
OH
01
—
350033709
RAILROAD MEDICARE
OH
01
—
367277
WELLCARE
OH
01
—
4332074
AETNA
OH
Enumeration date
03/06/2006
Last updated
05/12/2008
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