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Organization

JEFFRY M SMITH D C

Active
Other names
Coastal Chiropractic Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFRY MICHAEL SMITH D.C. (OWNER/PRESIDENT)
(912) 264-2424
Entity
Organization

Contact information

Practice address
4109 ALTAMA AVE, BRUNSWICK, GA 31520-3636
(912) 264-2424
(912) 264-2911
Mailing address
4109 ALTAMA AVE, BRUNSWICK, GA 31520-3636
(912) 264-2424
(912) 264-2911

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2236
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP1151
MEDICARE GROUP NUMBER
GA
Enumeration date
01/03/2008
Last updated
04/25/2013
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