Organization
COLEMAN CHIROPRACTIC SPORTS CARE P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRON COLEMAN DC (PRESIDENT/OWNER)
(708) 338-3446
Entity
Organization
Contact information
Practice address
110 S 5TH AVE, MAYWOOD, IL 60153-1308
(708) 338-3446
Mailing address
110 S 5TH AVE, MAYWOOD, IL 60153-1308
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623158
BCBS
IL
Enumeration date
04/09/2008
Last updated
04/09/2008
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