Provider Demographics
NPI:1831472828
Name:COFFMAN, EMILY M (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1570 BEAM AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3137
Mailing Address - Country:US
Mailing Address - Phone:651-326-1905
Mailing Address - Fax:651-232-7832
Practice Address - Street 1:1570 BEAM AVE STE 200
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-3137
Practice Address - Country:US
Practice Address - Phone:651-326-1905
Practice Address - Fax:651-232-7832
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60229030225100000X
MN9503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist