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Organization
PALM COAST SPORTS MEDICINE AND REHAB
Active
Organization
PALM COAST SPORTS MEDICINE AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDITH LYNN OT (ADMINISTRATOR)
(386) 445-5555
Entity
Organization
Contact information
Practice address
35 OLD KINGS RD N, PALM COAST, FL 32137-8227
(386) 445-5555
(386) 445-9800
Mailing address
35 OLD KINGS RD N, PALM COAST, FL 32137-8227
(386) 445-5555
(386) 445-9800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0010163
FL
225100000X
Physical Therapist
4154
FL
225X00000X
Occupational Therapist
Primary
1549
FL
235Z00000X
Speech-Language Pathologist
SA6443
FL
Other
Enumeration date
05/13/2008
Last updated
05/27/2008
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