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Organization
COASTAL INJURY CLINIC LLC
Active
Organization
COASTAL INJURY CLINIC LLC
Active
Parent organization
PHYSICIANS GROUP SERVICES PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIANS GROUP SERVICES PA
Authorized official
ANDREW T CHRISTMAN (CEO)
(941) 685-7688
Entity
Organization
Contact information
Practice address
2700 RIVERSIDE AVE STE 1, JACKSONVILLE, FL 32205-8233
(904) 559-6638
(888) 927-0401
Mailing address
PO BOX 1869, ORANGE PARK, FL 32067-1869
(904) 559-6638
(888) 927-0401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
07/29/2020
Last updated
04/26/2024
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