Organization
SALUTARIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON COFFMAN (AUTHORIZED OFFICIAL)
(804) 592-6249
Entity
Organization
Contact information
Practice address
7400 BEAUFONT SPRINGS DR STE 300, NORTH CHESTERFIELD, VA 23225-5519
(804) 893-3344
Mailing address
PO BOX 1191, MIDLOTHIAN, VA 23113-8191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
06/19/2017
Last updated
06/21/2017
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