Healthcare Provider Details

I. General information

NPI: 1588581128
Provider Name (Legal Business Name): EMERALD COAST CRYOTHERAPY, PERFORMANCE & RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 FURLING LN STE 10
DESTIN FL
32541-5422
US

IV. Provider business mailing address

4495 FURLING LN STE 10
DESTIN FL
32541-5422
US

V. Phone/Fax

Practice location:
  • Phone: 850-279-4145
  • Fax:
Mailing address:
  • Phone: 850-279-4145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MS. AMY H MILLIGAN
Title or Position: OWNER/GM
Credential:
Phone: 850-279-4145