Organization
COAST PAIN RELIEF CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDSAY NICOLE PETTY (OFFICE MANAGER)
(772) 873-5552
Entity
Organization
Contact information
Practice address
3233 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-3490
(772) 873-5552
(772) 873-5747
Mailing address
3233 SW PORT ST. LUCIE BLVD, PORT ST. LUCIE, FL 34953-3490
(772) 873-5552
(772) 873-5747
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME 62002
FL
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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