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General NPI Number Information
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NPI Number | 1740328368
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Entity Type | Organization
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Legal Business Name | COASTAL HAND THERAPY AND REHABILITATION INC
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 14546 SAINT AUGUSTINE RD SUITE 405
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5468
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Country | US
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Telephone | 904-318-8818
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Fax | 904-737-9850
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Provider Business Mailing Address
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Address Line | 3724 CATHEDRAL OAKS PL N
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4210
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Country | US
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Telephone | 904-318-8818
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Fax | 904-737-9850
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL ANTHONY FRIEDLIN
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Credential | OT, CHT
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Telephone | 904-318-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT4237
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License Number State | FL
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