Organization
FULL LIFE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVORIE COLEMAN MD (PHYSICIAN)
(480) 888-5029
Entity
Organization
Contact information
Practice address
9475 E IRONWOOD SQUARE DR STE 102, SCOTTSDALE, AZ 85258-4576
(480) 888-5029
Mailing address
9475 E IRONWOOD SQUARE DR STE 102, SCOTTSDALE, AZ 85258-4576
(480) 888-5029
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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