| Coastal Spine And Sport Of Daytona Beach | |
|
912 S Ridgewood Ave Ste. D Daytona Beach FL 32114-5349 | |
| (407) 496-7998 | |
| Not Available |
| Full Name | Coastal Spine And Sport Of Daytona Beach |
|---|---|
| Speciality | Clinic/center |
| Location | 912 S Ridgewood Ave, Daytona Beach, Florida |
| Authorized Official Name and Position | Chris Lee Wojcik (MANAGING MEMBER) |
| Authorized Official Contact | 4074967998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Spine And Sport Of Daytona Beach 912 S Ridgewood Ave Ste. D Daytona Beach FL 32114-5349 Ph: () - | Coastal Spine And Sport Of Daytona Beach 912 S Ridgewood Ave Ste. D Daytona Beach FL 32114-5349 Ph: (407) 496-7998 |
| NPI Number | 1346679610 |
|---|---|
| Provider Enumeration Date | 11/06/2013 |
| Last Update Date | 11/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346679610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH9679 (Florida) | Primary |
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