Provider Demographics
NPI:1922208149
Name:COLETTI, JEAN M (LPT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:COLETTI
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ELM DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-8767
Mailing Address - Country:US
Mailing Address - Phone:828-273-3950
Mailing Address - Fax:828-585-2359
Practice Address - Street 1:38 ROSSCRAGGON RD STE B
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1165
Practice Address - Country:US
Practice Address - Phone:828-273-3950
Practice Address - Fax:828-585-2359
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6754OtherBCBS PIN