Provider Demographics
NPI:1790329696
Name:COLEMAN, JAMES (HEARING AID FITTER)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:HEARING AID FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-2049
Mailing Address - Country:US
Mailing Address - Phone:570-876-1646
Mailing Address - Fax:
Practice Address - Street 1:1418 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2049
Practice Address - Country:US
Practice Address - Phone:570-876-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03783237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty