Provider Demographics
NPI:1083474795
Name:COASTAL HAND THERAPY, PC
Entity Type:Organization
Organization Name:COASTAL HAND THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:OT/L, CHT
Authorized Official - Phone:334-315-9729
Mailing Address - Street 1:25027 FAIRFAX RD
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-8267
Mailing Address - Country:US
Mailing Address - Phone:334-315-9729
Mailing Address - Fax:
Practice Address - Street 1:317 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1926
Practice Address - Country:US
Practice Address - Phone:251-943-0441
Practice Address - Fax:251-943-0441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty