Organization
EAST COAST MEDICAL AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SHEPHERD (DIRECTOR)
(973) 718-2635
Entity
Organization
Contact information
Practice address
908 MAIN STREET SUITE A, ASBURY PARK, NJ 07712
(973) 718-2835
Mailing address
908 MAIN STREET SUITE A, ASBURY PARK, NJ 07712
(973) 718-2835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA08719200
NJ
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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