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Individual

MS. PATRICE COATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21841 KENOSHA ST, OAK PARK, MI 48237-2651
(313) 218-2936
Mailing address
21841 KENOSHA ST, OAK PARK, MI 48237-2651
(313) 218-2936

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
224P00000X
Prosthetist
225000000X
Orthotic Fitter
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
Customized Equipment (DME)
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1962840124
NPI
Enumeration date
06/10/2013
Last updated
06/19/2024
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