Organization
COAST HAND THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH ALBERT CHURCH III OTR/L-CHT (OWNER)
(228) 575-4654
Entity
Organization
Contact information
Practice address
1105 39TH AVE, GULFPORT, MS 39501-2654
(228) 575-4654
(228) 575-4651
Mailing address
1105 39TH AVE, GULFPORT, MS 39501-2654
(228) 575-4654
(228) 575-4651
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT0116
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09382312
—
MS
Enumeration date
06/02/2006
Last updated
01/31/2013
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