# COASTAL PHYSICAL THERAPY INC

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

## Provider details

- **NPI number:** 1700844578
- **Authorized official:** MR. THOMAS A HETHERINGTON PT OCS FAAOMPT CFMT (OWNER)
- **Authorized official phone:** (843) 986-9670

## Contact information

- **Practice address:** 18 PROFESSIONAL VILLAGE CIRCLE, BEAUFORT, SC 29907
- **Practice address phone:** (843) 986-9670
- **Practice address fax:** (843) 986-9369
- **Mailing address:** 18 PROFESSIONAL VILLAGE CIRCLE, BEAUFORT, SC 29907
- **Mailing address phone:** (843) 986-9670
- **Mailing address fax:** (843) 986-9369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | SC2123 | SC | Yes |

## Other

- **Enumeration date:** 05/02/2006
- **Last updated:** 09/22/2011