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Individual

MR. CLARENCE BARKLEY COGGIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
3036 N BOLDT DR, FLAGSTAFF, AZ 86001-0960
(928) 773-0895
Mailing address
6215 RINKER CIR, FLAGSTAFF, AZ 86004-5561
(928) 637-4444

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7456
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT7456
PHYSICAL THERAPIST
AZ
Enumeration date
10/28/2006
Last updated
07/08/2007
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