COASTAL FOOT & ANKLE WELLNESS CENTER LLC
Medical Practice at Southpark Blvd, Saint Augustine, FL

License number
Florida P02829
Category
Medical Practice
Type
Foot & Ankle Surgery
Owner
Name: DR. RICHARD W JOHNSON DPM
Title: OWNER
Phone: (904) 826-1900
Address
Address
200 Southpark Blvd SUITE 208, Saint Augustine, FL 32086
National Provider ID: 1972834760
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about COASTAL FOOT & ANKLE WELLNESS CENTER LLC at bizstanding.com

Coastal Foot & Ankle and Wellness Center

200 Southpark Blvd, Saint Augustine, FL 32086

Industry:
Health/Allied Services
Doing business as:
Coastal Foot & Ankle Wellness Center, LLC
Registration:
Jan 12, 2010
State ID:
L10000004472
Business type:
Florida Limited Liability
Podiatrist, Principal, Managing Members:
Richard W S D Johnson (Managing Member),Jose M. Concha (Orthopedic Foot & Ankle, Managing Member),Richard W S Johnson Podiatrist, Principal, Managing Member, inactive
Agent:
Reznicsek, Fraser, White & Shaffer, Pa

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