Provider First Line Business Practice Location Address:
COASTAL FAMILY HEALTH CENTER
Provider Second Line Business Practice Location Address:
5052 STE A
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-864-4818
Provider Business Practice Location Address Fax Number:
228-864-4875
Provider Enumeration Date:
07/30/2006