Provider Demographics
NPI:1245537109
Name:CORONADO, NATHANIEL DAVID (DPT)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:DAVID
Last Name:CORONADO
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Gender:M
Credentials:DPT
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Mailing Address - Street 1:120 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1185
Mailing Address - Country:US
Mailing Address - Phone:205-909-2540
Mailing Address - Fax:205-682-3612
Practice Address - Street 1:120 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1185
Practice Address - Country:US
Practice Address - Phone:205-909-2540
Practice Address - Fax:205-682-3612
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2013-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALPTH60642251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic