Healthcare Provider Details

I. General information

NPI: 1265481840
Provider Name (Legal Business Name): SEA COAST PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 QUARTER HORSE LN
HAMPSTEAD NC
28443-3255
US

IV. Provider business mailing address

PO BOX 33955
DETROIT MI
48232-5900
US

V. Phone/Fax

Practice location:
  • Phone: 910-270-6488
  • Fax: 910-270-6489
Mailing address:
  • Phone: 910-270-6488
  • Fax: 910-270-6489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4855
License Number StateNC

VIII. Authorized Official

Name: DR. DAVID ARTHUR JOHNSON
Title or Position: OWNER
Credential: DPT
Phone: 910-270-6488