| Organization Name: | ATLANTIC COAST PHYSICAL THERAPY & WELLNESS CENTER, INC |
| NPI Number: | 1417353913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY G HARTLEY (OWNER) |
| Mailing Address: | 108 E H St Erwin |
| State: | NC US |
| Postal Code: | 283392144 |
| Phone Number: | 9107299651 |
| Fax Number: | |
| NPI Enumeration Date: | 11/10/2014 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | P6794 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |