Organization
COASTAL PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS E RUNYAN M.D. (MEDICAL DIRECTOR, PHYSICIAN)
(912) 466-9111
Entity
Organization
Contact information
Practice address
3221 GLYNN AVE, BRUNSWICK, GA 31520-4851
(912) 466-9111
(912) 466-0366
Mailing address
3221 GLYNN AVE, BRUNSWICK, GA 31520-4851
(912) 466-9111
(912) 466-0366
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
063-355
GA
Other
Enumeration date
01/26/2007
Last updated
02/14/2011
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