# COASTAL REHABILITATION OF SOUTH MISSISSIPPI

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

## Provider details

- **NPI number:** 1376651299
- **Authorized official:** MR. JOE FRAME PT (OWNER)
- **Authorized official phone:** (228) 831-4646

## Contact information

- **Practice address:** 15190 COMMUNITY RD, SUITE 110, GULFPORT, MS 39503-3485
- **Practice address phone:** (228) 831-4646
- **Mailing address:** 15190 COMMUNITY RD, SUITE 110, GULFPORT, MS 39503-3485
- **Mailing address phone:** (228) 831-4646

## Taxonomy

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

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08220738 | — | MS |
| 01 | — | 6408090089 | BCBS | MS |