Organization
COASTAL REJUVENATION SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA C CRAWFORD MSW (OWNER)
(843) 945-1452
Entity
Organization
Contact information
Practice address
630 CHESTNUT RD, MYRTLE BEACH, SC 29572-5502
(843) 945-1452
(843) 945-1489
Mailing address
630 CHESTNUT RD, MYRTLE BEACH, SC 29572-5502
(843) 945-1452
(843) 945-1489
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
163WG0000X
General Practice Registered Nurse
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
251B00000X
Case Management Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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