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1912576893
COASTAL LONGEVITY LLC
VIRGINIA BEACH, VA
NPI
1912576893
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Entity Type
Organization
Authorized Contact
MICHAEL LUCAS GAMBILL
CEO
804-840-8522
Organization Subpart ?
No
Primary Taxonomy
261QH0100X Clinic/Center, Health Services
Enumeration Date
2021-06-23
Last Update Date
2021-06-23
Business Address
COASTAL LONGEVITY LLC
3128 KLINE DR
VIRGINIA BEACH, VA 23452-6226
Phone number: 804-840-8522
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Mailing Address
COASTAL LONGEVITY LLC
3128 KLINE DR
VIRGINIA BEACH, VA 23452-6226
Phone number: 804-840-8522
Copy
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