Provider Demographics
NPI:1588272207
Name:COLEMAN, ROBERT BRENT JR (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRENT
Last Name:COLEMAN
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2121
Mailing Address - Country:US
Mailing Address - Phone:615-218-8918
Mailing Address - Fax:
Practice Address - Street 1:2501 RIVER RD
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-5402
Practice Address - Country:US
Practice Address - Phone:615-792-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist