Organization
PROMEDICAL FAMILY PRATICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAUDE VERNON COLEMAN LVN (ADMENISTRATOR)
(707) 407-0540
Entity
Organization
Contact information
Practice address
815 7TH ST, EUREKA, CA 95501-1113
(707) 407-0540
(707) 268-5573
Mailing address
815 7TH ST, EUREKA, CA 95501-1113
(707) 407-0540
(707) 268-5573
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
16089
CA
261QH0100X
Health Service Clinic/Center
Primary
G86543
CA
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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