Provider Demographics
NPI:1356034862
Name:COATS, MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:COATS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17337 RETFORD DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-3337
Mailing Address - Country:US
Mailing Address - Phone:260-409-1948
Mailing Address - Fax:
Practice Address - Street 1:1717 E 116TH ST STE 113
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3572
Practice Address - Country:US
Practice Address - Phone:260-409-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003207A111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty