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General NPI Number Information
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NPI Number | 1063305118
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Entity Type | Organization
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Legal Business Name | COASTAL CHIROPRACTIC L.L.C.
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1668 N PINE ST
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City | FOLEY
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State | AL
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Zip | 36535-2220
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Country | US
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Telephone | 843-793-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 27535 US HIGHWAY 98
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City | DAPHNE
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State | AL
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Zip | 36526-4839
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Country | US
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Telephone | 843-793-9393
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR, OWNER
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Name | RYAN NOBLES
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Credential | DC
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Telephone | 251-375-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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