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General NPI Number Information
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NPI Number | 1104720234
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Entity Type | Organization
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Legal Business Name | COASTLINE THERAPY GROUP, LLC
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 3901 WRIGHTSVILLE AVE STE 120
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City | WILMINGTON
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State | NC
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Zip | 28403-6256
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Country | US
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Telephone | 910-679-8385
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Fax | 910-679-8387
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Provider Business Mailing Address
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Address Line | 4936 PLEASANT GROVE DR
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City | WILMINGTON
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State | NC
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Zip | 28412-2288
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Country | US
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Telephone | 252-299-6703
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MADISON PYLE
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Credential | OTD, OTR/L, B.S.
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Telephone | 252-299-6703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | NULL
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