Provider Demographics
NPI:1811267248
Name:COATES, CLAIRE G (MS, AT, ATC)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:G
Last Name:COATES
Suffix:
Gender:F
Credentials:MS, AT, ATC
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:E
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6664 BUCK XING
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6838
Mailing Address - Country:US
Mailing Address - Phone:941-524-0073
Mailing Address - Fax:
Practice Address - Street 1:1000 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109
Practice Address - Country:US
Practice Address - Phone:734-763-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2601001247246Z00000X
FLAL 27172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2000001652OtherNATIONAL ATHLETIC TRAINERS' BOARD OF CERTIFICATION, INC.