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General NPI Number Information
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NPI Number | 1700405040
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Entity Type | Organization
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Legal Business Name | COASTAL PAIN RELIEF CONSULTANTS, LLC
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 315 COMMERCIAL DR STE C5
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City | SAVANNAH
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State | GA
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Zip | 31406-3633
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Country | US
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Telephone | 912-355-3170
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Fax | 912-355-3171
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Provider Business Mailing Address
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Address Line | 1207 BELLE ISLAND RD
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City | RICHMOND HILL
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State | GA
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Zip | 31324-6028
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Country | US
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Telephone | 912-665-2458
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY PEARSON
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Credential | MD
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Telephone | 912-665-2458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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