Individual
THOMAS COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6110 SAPPHIRE TRL, FORT WAYNE, IN 46804-6290
(260) 418-1520
Mailing address
6110 SAPPHIRE TRL, FORT WAYNE, IN 46804-6290
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IN
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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