Organization
COASTAL THERAPY LLC
Active
Other names
Coastal Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN CARLOS SWOOPES MPT (OWNER/PT)
(805) 598-6982
Entity
Organization
Contact information
Practice address
633 HAWKINS WAY, SANTA MARIA, CA 93455-7427
(805) 598-6982
Mailing address
633 HAWKINS WAY, SANTA MARIA, CA 93455-7427
(805) 598-6982
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
11/06/2023
Last updated
03/07/2024
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