Provider Demographics
NPI:1518464684
Name:COLEMAN, HEATHER (MRI TECH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MRI TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-3710
Mailing Address - Country:US
Mailing Address - Phone:205-243-2738
Mailing Address - Fax:
Practice Address - Street 1:407 ENCLAVE DR
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-3710
Practice Address - Country:US
Practice Address - Phone:205-243-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4207782471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging