# COASTAL THERAPEUTICS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275622029
- **Authorized official:** MRS. VICTORIA ELIZABETH CONNELLY PT (PRESIDENT)
- **Authorized official phone:** (843) 884-4783

## Contact information

- **Practice address:** 570 LONG POINT RD, SUITE 270, MOUNT PLEASANT, SC 29464-7932
- **Practice address phone:** (843) 884-4783
- **Practice address fax:** (843) 884-4783
- **Mailing address:** 570 LONG POINT RD, SUITE 270, MOUNT PLEASANT, SC 29464-7932
- **Mailing address phone:** (843) 884-4783
- **Mailing address fax:** (843) 884-4783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 08/22/2020