Organization
COASTAL THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON THAYER CCC-SLP (OWNER)
(843) 216-0290
Entity
Organization
Contact information
Practice address
1127 QUEENSBOROUGH BLVD STE 104, MT PLEASANT, SC 29464-5431
(843) 216-0290
(843) 216-2445
Mailing address
PO BOX 1753, MT PLEASANT, SC 29465-1753
(843) 216-0290
(843) 216-2445
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3250
—
SC
Enumeration date
08/02/2006
Last updated
06/23/2015
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