Individual
MR. MICHAEL PAUL COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
601 D STREET, GREAT LAKES, IL 60088-2822
(847) 688-4903
Mailing address
601 D ST, GREAT LAKES, IL 60088-2822
(847) 688-4903
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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