| NPI | 1124292867 | 
|---|---|
| Doing Business As | COASTAL INTEGRATIVE MEDICINE | 
| Entity Type | Organization | 
| Authorized Contact | LISA M RANKIN Owner/Agent 772-344-1409  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0074325)  | 
| Enumeration Date | 2008-04-14 | 
| Last Update Date | 2012-01-24 |