Provider Demographics
NPI:1700649662
Name:COATNEY, CAROL ASHLEY (DAOM)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ASHLEY
Last Name:COATNEY
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S CAESAR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-5914
Mailing Address - Country:US
Mailing Address - Phone:559-307-8059
Mailing Address - Fax:
Practice Address - Street 1:1715 S CAESAR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-5914
Practice Address - Country:US
Practice Address - Phone:559-307-8059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist