Provider Demographics
NPI:1225076292
Name:COASTAL THERAPY SOLUTIONS PC
Entity Type:Organization
Organization Name:COASTAL THERAPY SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCONKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-971-7878
Mailing Address - Street 1:PO BOX 1732
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-1732
Mailing Address - Country:US
Mailing Address - Phone:251-971-7878
Mailing Address - Fax:251-971-7865
Practice Address - Street 1:27250C PERDIDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3205
Practice Address - Country:US
Practice Address - Phone:251-971-7878
Practice Address - Fax:251-971-7865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty