Provider Demographics
NPI:1255578340
Name:COLEY, ERIC THOMAS (PT, ATC, CSCS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:THOMAS
Last Name:COLEY
Suffix:
Gender:M
Credentials:PT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 CAMPUS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-9701
Mailing Address - Country:US
Mailing Address - Phone:276-628-6043
Mailing Address - Fax:
Practice Address - Street 1:611 CAMPUS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-9701
Practice Address - Country:US
Practice Address - Phone:276-628-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist