Organization
EMERALD COAST PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT MCKINNEY (DIRECTOR OF OPERATIONS)
(850) 714-6166
Entity
Organization
Contact information
Practice address
35008 EMERALD COAST PKWY STE 400, DESTIN, FL 32541-4753
(850) 714-6166
(850) 714-6166
Mailing address
35008 EMERALD COAST PKWY STE 400, DESTIN, FL 32541-4753
(850) 714-6166
(850) 714-6167
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
261Q00000X
Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/27/2019
Last updated
02/14/2023
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