Provider Demographics
NPI:1427289453
Name:COLEMAN, LANAY MARRTENE (MS, ATC)
Entity type:Individual
Prefix:MS
First Name:LANAY
Middle Name:MARRTENE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 CORAL KEY PL
Mailing Address - Street 2:1C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4335
Mailing Address - Country:US
Mailing Address - Phone:757-243-8304
Mailing Address - Fax:
Practice Address - Street 1:532 CORAL KEY PL
Practice Address - Street 2:1C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4335
Practice Address - Country:US
Practice Address - Phone:757-243-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260013982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer