Provider Demographics
NPI:1144907981
Name:PALM COAST MOBILE PHYSICAL THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:PALM COAST MOBILE PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ELFRINK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:407-718-1910
Mailing Address - Street 1:17 CHERRYTREE CT
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9050
Mailing Address - Country:US
Mailing Address - Phone:407-718-1910
Mailing Address - Fax:
Practice Address - Street 1:17 CHERRYTREE CT
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9050
Practice Address - Country:US
Practice Address - Phone:407-718-1910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy