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1639705387
COASTAL REGENEX LTD
CHESAPEAKE, VA
NPI
1639705387
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Entity Type
Organization
Authorized Contact
TREY WILLIAMS
Owner
757-297-6750
Organization Subpart ?
No
Primary Taxonomy
261QM1300X Clinic/Center, Multi-Specialty
Enumeration Date
2020-03-13
Last Update Date
2020-03-13
Business Address
COASTAL REGENEX LTD
1013 EDEN WAY N STE B
CHESAPEAKE, VA 23320-2792
Phone number: 757-297-6750
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Mailing Address
COASTAL REGENEX LTD
182 ODD RD
POQUOSON, VA 23662-2035
Phone number: 757-297-6750
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