Organization
COASTAL CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN L GOLDBERG DC (CEO)
(912) 351-0875
Entity
Organization
Contact information
Practice address
7370 HODGSON MEMORIAL DR, STE E3, SAVANNAH, GA 31406-2536
(912) 351-0875
Mailing address
7370 HODGSON MEMORIAL DR, STE E3, SAVANNAH, GA 31406-2536
(912) 351-0875
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002514
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCBCB
MEDICARE IDENTIFICATION NUMBER
GA
Enumeration date
08/05/2008
Last updated
12/03/2009
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