Provider Demographics
NPI:1962258723
Name:COLEMAN BODYWORK LLC
Entity type:Organization
Organization Name:COLEMAN BODYWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-294-0010
Mailing Address - Street 1:5052 OLD BUNCOMBE RD STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-8260
Mailing Address - Country:US
Mailing Address - Phone:864-294-0010
Mailing Address - Fax:864-294-8221
Practice Address - Street 1:5052 OLD BUNCOMBE RD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-8260
Practice Address - Country:US
Practice Address - Phone:864-294-0010
Practice Address - Fax:864-294-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty