Most Relevant Information
Provider Data
| NPI Number: | 1003324583 |
| Provider Name: | LORI COLEMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 32001544A |
Most Important Dates
| Enumeration Date: | 01/18/2018 |
| Last Updated: | 01/18/2018 |
Provider Practice Location
1400 MEDICAL PARK DR
FORT WAYNE
IN
468255832
Practice Location Phone/Fax
| Phone: | 2604841558 |
| Fax: |
Provider Mailing Location
1716 DUNDEE DR
NEW HAVEN
IN
467742220
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |