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Individual

ANDRE A COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
4110 S WATER TOWER PLACE, MOUNT VERNON, IL 62864-6567
(618) 242-1100
(618) 244-5148
Mailing address
4110 S WATER TOWER PLACE, MOUNT VERNON, IL 62864-6567
(618) 242-1100
(618) 244-5148

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009596
IL

Other

Enumeration date
12/27/2011
Last updated
02/02/2012
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