Provider Demographics
NPI:1366034837
Name:COFFMAN, CZARMI ANN (PT)
Entity Type:Individual
Prefix:
First Name:CZARMI
Middle Name:ANN
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 HIDDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42261-8550
Mailing Address - Country:US
Mailing Address - Phone:270-526-1111
Mailing Address - Fax:
Practice Address - Street 1:227 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:KY
Practice Address - Zip Code:42320-2131
Practice Address - Country:US
Practice Address - Phone:270-274-9221
Practice Address - Fax:270-955-2003
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty