Individual
CRAIG COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2222 S 114TH ST, WEST ALLIS, WI 53227-1031
(414) 449-4444
Mailing address
2222 S 114TH ST, WEST ALLIS, WI 53227-1031
(414) 449-4444
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
C455-1178-7344-08
WI
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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