Provider Demographics
NPI:1962218610
Name:COAST CHIROPRACTIC P.A.
Entity type:Organization
Organization Name:COAST CHIROPRACTIC P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-370-9616
Mailing Address - Street 1:4303 CHICOT ST
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-4701
Mailing Address - Country:US
Mailing Address - Phone:563-370-9616
Mailing Address - Fax:
Practice Address - Street 1:4303 CHICOT ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-4701
Practice Address - Country:US
Practice Address - Phone:228-762-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty