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Individual

AMANDA MICHELLE COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2712 WAKEFIELD DR APT H, JONESBORO, AR 72404-7793
(870) 926-5749
Mailing address
2712 WAKEFIELD DR APT H, JONESBORO, AR 72404-7793
(870) 926-5749

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
993239
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
993239
NATA MEMBER
AR
Enumeration date
01/03/2007
Last updated
07/08/2007
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