Individual
JEFFREY ALAN COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
2100 COLLEGE ST, NEWBERRY, SC 29108-2126
(803) 321-5184
(800) 882-9648
Mailing address
100 WALDEN HEIGHTS DR, APT 513, IRMO, SC 29063-7865
(803) 673-9498
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1398
SC
Other
Enumeration date
10/15/2012
Last updated
01/30/2015
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