| Coastal Neuropsychiatry, Pa | |
|
132 Professional Park Dr Suite B Conway SC 29526-9260 | |
| (843) 347-0356 | |
| (843) 347-0390 |
| Full Name | Coastal Neuropsychiatry, Pa |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 132 Professional Park Dr, Conway, South Carolina |
| Authorized Official Name and Position | William Archie Van Horn (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8433470356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Neuropsychiatry, Pa 132 Professional Park Dr Suite B Conway SC 29526-9260 Ph: (843) 347-0356 | Coastal Neuropsychiatry, Pa 132 Professional Park Dr Suite B Conway SC 29526-9260 Ph: (843) 347-0356 |
| NPI Number | 1083859318 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 12/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083859318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 0TP-0100 (South Carolina) | Primary |
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