Provider Demographics
NPI:1598309189
Name:COOMBS, CAITLIN J
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:J
Last Name:COOMBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 W 43RD ST
Mailing Address - Street 2:# 100
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1696
Mailing Address - Country:US
Mailing Address - Phone:612-767-4680
Mailing Address - Fax:612-605-2281
Practice Address - Street 1:3390 COACHMAN RD STE 214
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1800
Practice Address - Country:US
Practice Address - Phone:651-452-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor