COASTAL PODIATRY, LLC

MOUNT PLEASANT, SC
NPI1659648152
Entity TypeOrganization
Authorized ContactTAMIKA MICHELLE BOLDEN RAVENELL
Owner
916-215-1234
Organization Subpart ?No
Primary Taxonomy213E00000X Podiatrist
(Licence: SC  607)
Enumeration Date2011-11-28
Last Update Date2013-12-13
Business Address
COASTAL PODIATRY, LLC
180 WINGO WAY SUITE 201
MOUNT PLEASANT, SC 29464-1810
Phone number: 916-215-1234
Mailing Address
COASTAL PODIATRY, LLC
PO BOX 783
MOUNT PLEASANT, SC 29465-0783
Phone number: 916-215-1234
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