| Organization Name: | PALM COAST SPORTS MEDICINE AND REHAB |
| NPI Number: | 1932376555 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDITH LYNN (ADMINISTRATOR) |
| Mailing Address: | 35 Old Kings Rd N Palm Coast |
| State: | FL US |
| Postal Code: | 321378227 |
| Phone Number: | 3864455555 |
| Fax Number: | 3864459800 |
| NPI Enumeration Date: | 05/13/2008 |
| NPI Last Update Date: | 05/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 0010163 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |