Provider Demographics
NPI:1265508741
Name:COLEMAN, JANET MARIE (MSPT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 ROUTE 315
Mailing Address - Street 2:PRO REHABILITATION SERVICES
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-823-7761
Mailing Address - Fax:570-822-8033
Practice Address - Street 1:1086 ROUTE 315
Practice Address - Street 2:PRO REHABILITATION SERVICES
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-823-7761
Practice Address - Fax:570-822-8033
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013534L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
818049OtherFIRST PRIORITY
1523080OtherBLUE SHIELD
393517OtherHEALTH AMERICA ASSURANCE
388434OtherHEALTH AMERICA ASSURANCE
393518OtherHEALTH AMERICA ASSURANCE
814183OtherFIRST PRIORITY
818050OtherFIRST PRIORITY