Organization
COASTAL REGENEX LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREY WILLIAMS DO (OWNER)
(757) 297-6750
Entity
Organization
Contact information
Practice address
1013 EDEN WAY N STE B, CHESAPEAKE, VA 23320-2792
(757) 297-6750
(757) 609-3473
Mailing address
182 ODD RD, POQUOSON, VA 23662-2035
(757) 297-6750
(757) 609-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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