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General NPI Number Information
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NPI Number | 1881527109
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Entity Type | Organization
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Legal Business Name | COASTAL FOOT & ANKLE CENTER LLC
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 69 TOWNE DR
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City | BLUFFTON
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State | SC
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Zip | 29910-4201
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Country | US
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Telephone | 910-382-8480
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 FORDING ISLAND RD STE C
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City | BLUFFTON
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State | SC
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Zip | 29910-8667
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Country | US
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Telephone | 910-382-8480
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN THORNBERRY
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Credential | DPM
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Telephone | 910-382-8480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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