Provider Demographics
NPI:1972983575
Name:COASTAL PHYSICAL THERAPY AND LYMPHEDEMA MANAGEMENT, LLC
Entity type:Organization
Organization Name:COASTAL PHYSICAL THERAPY AND LYMPHEDEMA MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA-KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CLT
Authorized Official - Phone:251-981-7778
Mailing Address - Street 1:25910 CANAL RD
Mailing Address - Street 2:SUITE P
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-5014
Mailing Address - Country:US
Mailing Address - Phone:251-982-7778
Mailing Address - Fax:
Practice Address - Street 1:25910 CANAL RD
Practice Address - Street 2:SUITE P
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-5014
Practice Address - Country:US
Practice Address - Phone:251-981-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH63572251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonaryGroup - Single Specialty