Individual
ELLIS COLEMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 N FAIRFAX ST # 1016, ALEXANDRIA, VA 22314-2070
(703) 260-9860
Mailing address
1010 N FAIRFAX ST # 1016, ALEXANDRIA, VA 22314-2070
(703) 260-9860
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
IM1646
VA
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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