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General NPI Number Information
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NPI Number | 1932101227
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Entity Type | Organization
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Legal Business Name | COASTAL ORTHOTICS AND PROSTHETICS LLC
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 4600 HIGHWAY 22 STE 1
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City | MANDEVILLE
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State | LA
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Zip | 70471-2891
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Country | US
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Telephone | 985-626-1135
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Fax | 985-626-1174
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Provider Business Mailing Address
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Address Line | 4600 HIGHWAY 22 STE 1
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City | MANDEVILLE
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State | LA
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Zip | 70471-2891
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Country | US
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Telephone | 985-626-1135
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Fax | 985-626-1174
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN NORTHEY
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Credential | C.P./C.O.F.
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Telephone | 985-626-1135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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