Individual
JILL COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 NW 3RD ST, EAGLE GROVE, IA 50533-1308
(515) 448-9008
Mailing address
321 NW 3RD ST, EAGLE GROVE, IA 50533-1308
(515) 448-9008
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0737841
—
IA
Enumeration date
05/29/2007
Last updated
07/09/2007
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