Provider Demographics
NPI:1902833528
Name:COLEMAN, TERRANCE M (DC)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:M
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 ROUTE 88 SUITE #5
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742
Mailing Address - Country:US
Mailing Address - Phone:732-892-8488
Mailing Address - Fax:732-892-2025
Practice Address - Street 1:2911 ROUTE 88
Practice Address - Street 2:STE 5
Practice Address - City:PT PLEASANT
Practice Address - State:NJ
Practice Address - Zip Code:08742-2871
Practice Address - Country:US
Practice Address - Phone:732-892-8488
Practice Address - Fax:732-892-2025
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 02640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor