Individual
PAUL C COFFEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1830 STATE HIGHWAY 9, DECORAH, IA 52101-7301
(563) 382-2639
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1251
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42989700
—
WI
Enumeration date
05/18/2006
Last updated
09/25/2013
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