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Individual

TIMOTHY KITT COAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
1514 OWENS ST, GADSDEN, AL 35904-4938
(256) 543-1030
(256) 439-2830
Mailing address
1514 OWENS ST, GADSDEN, AL 35904-4938
(256) 543-1030
(256) 439-2830

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH5587
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200907931
PTH 5587
AL
Enumeration date
07/20/2009
Last updated
07/20/2009
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