Provider Demographics
NPI:1336495050
Name:COLEMAN, KEVIN N (DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:N
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OFFICE PARK CIR
Mailing Address - Street 2:STE 217
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:3125 INDEPENDENCE DR
Practice Address - Street 2:STE 300B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4168
Practice Address - Country:US
Practice Address - Phone:205-879-7501
Practice Address - Fax:205-879-0675
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist