Individual
TAMMY COATSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL PARK, WHEELING HOSPITAL INC, WHEELING, WV 26003
(304) 243-3124
(304) 243-6343
Mailing address
1839 JEFFERSON AVENUE, WASHINGTON, PA 15301
(724) 223-1790
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
694
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5135
STATE LICENSE
OH
01
—
OC005670L
STATE LICENSE
PA
Enumeration date
01/17/2007
Last updated
07/08/2007
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