Individual
RANDY COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
52303 CARRIAGE HILLS DR, SOUTH BEND, IN 46635-1011
(574) 272-1160
Mailing address
52303 CARRIAGE HILLS DR, SOUTH BEND, IN 46635-1011
(574) 272-1160
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004768A
IN
Other
Enumeration date
03/28/2021
Last updated
03/28/2021
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