| NPI | 1235632449 |
|---|---|
| Former Legal Business Name | COASTAL GEORGIA WELLNESS CENTER & FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | TAVIA HALL Clinical Director 912-576-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2024-06-14 |