Provider Demographics
NPI:1396300216
Name:COASTAL THERAPY INC
Entity type:Organization
Organization Name:COASTAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E H
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:626-461-5350
Mailing Address - Street 1:123 E DUARTE RD
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3935
Mailing Address - Country:US
Mailing Address - Phone:626-461-5350
Mailing Address - Fax:626-462-9695
Practice Address - Street 1:123 E DUARTE RD
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3935
Practice Address - Country:US
Practice Address - Phone:626-461-5350
Practice Address - Fax:626-462-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty