Provider Demographics
NPI:1528186616
Name:COLEMAN CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:COLEMAN CHIROPRACTIC, PLLC
Other - Org Name:COLEMAN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-587-5805
Mailing Address - Street 1:1775 W MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2835
Mailing Address - Country:US
Mailing Address - Phone:423-587-5805
Mailing Address - Fax:423-587-3311
Practice Address - Street 1:1775 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2835
Practice Address - Country:US
Practice Address - Phone:423-587-5805
Practice Address - Fax:423-587-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNV05497Medicare UPIN
TN3973229Medicare ID - Type UnspecifiedDR. CARRIE COLEMAN
TN3973585Medicare ID - Type UnspecifiedDR. PHILLIP COLEMAN
TNV02332Medicare UPIN