Organization
COASTAL FAMILY CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW LEACH DC (PRESIDENT)
(772) 337-2748
Entity
Organization
Contact information
Practice address
10504 S FEDERAL HWY, PORT ST LUCIE, FL 34952-5603
(772) 337-2748
(772) 337-1764
Mailing address
10504 S FEDERAL HWY, PORT ST LUCIE, FL 34952-5603
(772) 337-2748
(772) 337-1764
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0008232
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97454
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/03/2006
Last updated
08/22/2020
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