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Organization

COASTAL BREEZE CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUSSELL DUNCAN EDGAR D.C. (PRESIDENT)
(910) 575-7809
Entity
Organization

Contact information

Practice address
109 CAUSEWAY DR STE 6, OCEAN ISLE BEACH, NC 28469-7523
(910) 575-7809
Mailing address
PO BOX 6931, OCEAN ISLE BEACH, NC 28469-0931
(910) 575-7809

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2207
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7908776
NC
Enumeration date
11/07/2006
Last updated
08/07/2007
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