Provider Demographics
NPI:1326336629
Name:COATES, LINDA J (PTA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:COATES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:179 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1158
Mailing Address - Country:US
Mailing Address - Phone:508-347-8141
Mailing Address - Fax:508-347-7576
Practice Address - Street 1:179 MAIN ST
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1158
Practice Address - Country:US
Practice Address - Phone:508-347-8141
Practice Address - Fax:508-347-7576
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8527225200000X
CT1185225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant