| NPI | 1427133891 |
|---|---|
| Doing Business As | PALM COAST SPORTS MEDICINE & REHAB CENTER INC |
| Entity Type | Organization |
| Authorized Contact | EDITH ELIZABETH LYNN-MCCOY Owner/Administrater 386-445-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL PT19692) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL OT1549) |
| 174400000X Specialist (Licence: FL SA6443) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-02-20 |