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Individual

KELLI ANN COLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL CHT

Contact information

Practice address
690 N COFCO CENTER CT, SUITE 260, PHOENIX, AZ 85008-6462
(602) 279-6905
(888) 445-4263
Mailing address
690 N COFCO CENTER CT, SUITE 260, PHOENIX, AZ 85008-6462
(602) 279-6905
(888) 445-4263

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
3119
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
886260
AZ
01
Z113264
MEDICARE GROUP
AZ
Enumeration date
10/11/2005
Last updated
11/08/2007
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