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General NPI Number Information
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NPI Number | 1346466430
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Entity Type | Organization
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Legal Business Name | COASTAL REHABILITATION INC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 503 CYPRESS LN SUITE A
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City | MANTEO
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State | NC
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Zip | 27954-8016
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Country | US
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Telephone | 252-473-9633
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Fax | 252-473-9635
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Provider Business Mailing Address
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Address Line | 101 MEDICAL DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3361
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Country | US
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Telephone | 252-338-2114
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Fax | 252-338-2115
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MEGAN ELIZABETH MORNINGSTAR
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Credential |
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Telephone | 252-338-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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