Organization
COASTAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLEISCHA OWEN (MANAGER)
(407) 312-4613
Entity
Organization
Contact information
Practice address
6341 ENGRAM RD, NEW SMYRNA BEACH, FL 32169-4713
(904) 251-5546
(407) 703-9754
Mailing address
6341 ENGRAM RD, NEW SMYRNA BEACH, FL 32169-4713
(904) 251-5546
(407) 703-9454
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
02/08/2024
Last updated
06/18/2024
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