Organization
THE COULTER CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORGAN BATES COULTER FNP (CLINIC OWNER, FNP)
(256) 780-0216
Entity
Organization
Contact information
Practice address
1405 SW JEFFERSON ST, ATHENS, AL 35611-3531
(256) 780-0216
(256) 780-0218
Mailing address
1405 SW JEFFERSON ST, ATHENS, AL 35611-3531
(256) 780-0216
(256) 780-0218
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-154372
PROVIDER LICENSE NUMBER
AL
Enumeration date
10/31/2024
Last updated
10/31/2024
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