Organization
NATURE COAST REHABILITATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH JOHNSON HICKS PT (OWNER/PRESIDENT)
(352) 528-0022
Entity
Organization
Contact information
Practice address
37 S MAIN ST STE C, WILLISTON, FL 32696-2681
(352) 528-0022
(352) 528-2878
Mailing address
PO BOX 518, WILLISTON, FL 32696-0518
(352) 528-0022
(352) 528-2878
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890647500
—
FL
01
—
Y911Y
PHYSICAL THERAPY-BCBS
FL
Enumeration date
04/27/2006
Last updated
01/20/2009
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