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Organization

LINA L FEASTER PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINA L FEASTER (PRESIDENT MD)
(904) 794-2424
Entity
Organization

Contact information

Practice address
2460 OLD MOULTRIE RD, SUITE 1, ST AUGUSTINE, FL 32086-4197
(904) 794-2424
Mailing address
PO BOX 3463, ST AUGUSTINE, FL 32085-3463
(904) 794-2424

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME79232
FL

Other

Enumeration date
06/29/2007
Last updated
11/20/2007
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