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Individual

ADAM MICHAEL COFFEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
9 N MARKET ST, NANTICOKE, PA 18634-1410
(570) 735-3114
(570) 735-7887
Mailing address
703 RUTTER AVE, KINGSTON, PA 18704-4801
(570) 288-7405
(570) 288-7406

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000853
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1303649
PA
Enumeration date
03/23/2006
Last updated
02/21/2014
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