Organization
COASTAL PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI DUNCAN GREEN M.P.T. (OWNER/PT)
(850) 378-2600
Entity
Organization
Contact information
Practice address
424 COLLEGE BLVD, VALPARAISO, FL 32580-1774
(850) 378-2600
(833) 869-6437
Mailing address
6021 STERLING RIVER WAY, NICEVILLE, FL 32578-1534
(850) 378-2600
(833) 869-6437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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