Organization
COASTAL ORTHOPEDIC PRODUCTS, INC.
Active
Organization
COASTAL ORTHOPEDIC PRODUCTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L PARKER III (SECRETARY)
(912) 258-2025
Entity
Organization
Contact information
Practice address
1900 SECOND STREET, BRUNSWICK, GA 31520
(912) 258-2025
(912) 638-6115
Mailing address
1479 BROCKETT RD, SUITE 101, TUCKER, GA 30084-7326
(912) 258-2025
(912) 638-6115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
GA
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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