# COASTAL HOME THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Home Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730559071
- **Authorized official:** TRAVIS SCOTT BROWN PT (PHYSICAL THERAPIST/ OWNER)
- **Authorized official phone:** (843) 455-9162

## Contact information

- **Practice address:** 1509 DEER PARK LN, SURFSIDE BEACH, SC 29575-5245
- **Practice address phone:** (843) 455-9162
- **Practice address fax:** (843) 595-4686
- **Mailing address:** 1509 DEER PARK LN, SURFSIDE BEACH, SC 29575-5245
- **Mailing address phone:** (843) 455-9162
- **Mailing address fax:** (843) 595-4686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 6522 | SC | Yes |

## Other

- **Enumeration date:** 09/29/2015
- **Last updated:** 09/29/2015