Provider Demographics
NPI:1649728049
Name:WEST COAST THERAPY SPECIALISTS
Entity type:Organization
Organization Name:WEST COAST THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-223-8978
Mailing Address - Street 1:4707 140TH AVE N
Mailing Address - Street 2:STE 313
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3834
Mailing Address - Country:US
Mailing Address - Phone:727-223-8978
Mailing Address - Fax:727-303-3952
Practice Address - Street 1:4707 140TH AVE N
Practice Address - Street 2:STE 313
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3834
Practice Address - Country:US
Practice Address - Phone:727-223-8978
Practice Address - Fax:727-303-3952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health