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General NPI Number Information
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NPI Number | 1023528841
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Entity Type | Organization
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Legal Business Name | COASTAL CARE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 6 ELLIS ALLEY UNIT 6
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City | SELBYVILLE
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State | DE
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Zip | 19975
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Country | US
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Telephone | 302-524-8333
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Fax | 302-524-8891
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Provider Business Mailing Address
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Address Line | 37197 E STONEY RUN
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City | SELBYVILLE
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State | DE
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Zip | 19975-4325
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Country | US
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Telephone | 302-524-8333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BIRAO S MARYCYST
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Credential | DPT
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Telephone | 302-524-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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