Organization
COASTAL REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN SCOTT LANCE PT, DPT, CLT, MLD-PP (OWNER/CEO)
(504) 811-1178
Entity
Organization
Contact information
Practice address
229 SOUTHWOOD DR, PANAMA CITY, FL 32405-4905
(850) 481-1117
(850) 373-4858
Mailing address
7113 LAGOON DR, PANAMA CITY BEACH, FL 32408-5509
(850) 257-6464
(850) 248-2469
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
01/13/2026
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