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Organization

COASTAL INJURY CLINIC LLC

Active
Parent organization
PHYSICIANS GROUP SERVICES PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
PHYSICIANS GROUP SERVICES PA
Authorized official
ANDREW T CHRISTMAN (CEO)
(941) 685-7688
Entity
Organization

Contact information

Practice address
2700 RIVERSIDE AVE STE 1, JACKSONVILLE, FL 32205-8233
(904) 559-6638
(888) 927-0401
Mailing address
PO BOX 1869, ORANGE PARK, FL 32067-1869
(904) 559-6638
(888) 927-0401

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
207X00000X
Orthopaedic Surgery Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
213E00000X
Podiatrist

Other

Enumeration date
07/29/2020
Last updated
04/26/2024
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