| Organization Name: | COASTAL PHYSICAL THERAPY SERVICES, LLC |
| NPI Number: | 1659687267 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER BEAL ANDERSON (PHYSICAL THERAPIST) |
| Mailing Address: | 1110 Main St Harrington |
| State: | ME US |
| Postal Code: | 04643 |
| Phone Number: | 2072717302 |
| Fax Number: | 2074832222 |
| NPI Enumeration Date: | 08/20/2010 |
| NPI Last Update Date: | 08/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT2403 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |