Organization
COASTAL WELLNESS FAMILY MEDICINE LLC
Active
Other names
Coastal Georgia Wellness Center & Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAVIA HALL MS, CPPM (CLINICAL DIRECTOR)
(912) 576-7546
Entity
Organization
Contact information
Practice address
102 LAKESHORE DR STE B, SAINT MARYS, GA 31558-3875
(912) 576-7546
(912) 576-2348
Mailing address
102 LAKESHORE DR STE B, SAINT MARYS, GA 31558-3875
(912) 576-7546
(912) 576-2348
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2018
Last updated
12/03/2024
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