Individual
CLINTARIUS COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3003 KNIGHT ST STE 115, SHREVEPORT, LA 71105-2561
(225) 993-3566
Mailing address
2206 STOCKWELL RD, BOSSIER CITY, LA 71111-5700
(225) 993-3566
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
08/01/2017
Last updated
11/18/2021
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