Organization
COASTAL VIRGINIA SPINE AND PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WARD (CREDENTIALING MANAGER)
(757) 340-3489
Entity
Organization
Contact information
Practice address
4525 SOUTH BLVD STE 200, VIRGINIA BEACH, VA 23452-1147
(757) 227-3820
(757) 226-9021
Mailing address
PO BOX 2546, VIRGINIA BEACH, VA 23450-2546
(757) 340-3489
(757) 340-4278
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
10/27/2022
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