Organization
COASTAL VIRGINIA SPINE AND PAIN CENTER LLC
Active
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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