Individual
COLEMAN ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1108 W MAIN ST STE B, JACKSONVILLE, AR 72076-4486
(501) 672-4188
Mailing address
97 OTTO RD, VILONIA, AR 72173-9422
(501) 672-4188
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7765
AR
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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