Provider Demographics
NPI:1972752038
Name:THE COLEMAN THERAPY CENTER
Entity Type:Organization
Organization Name:THE COLEMAN THERAPY CENTER
Other - Org Name:SPEAC,LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:BAER
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:571-242-2489
Mailing Address - Street 1:13602 FERNBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1797
Mailing Address - Country:US
Mailing Address - Phone:571-242-2489
Mailing Address - Fax:
Practice Address - Street 1:15109 LEE HWY
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2122
Practice Address - Country:US
Practice Address - Phone:571-242-2489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-14
Last Update Date:2008-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002982261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty