Organization
SOUTHCOAST PAIN AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA F. SHESTACK (CREDENTIALING MANAGER)
(508) 384-9424
Entity
Organization
Contact information
Practice address
651 ORCHARD ST, SUITE 206, NEW BEDFORD, MA 02744-1008
(508) 991-8400
(508) 991-8788
Mailing address
651 ORCHARD ST, SUITE 206, NEW BEDFORD, MA 02744-1008
(508) 991-8400
(508) 991-8788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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