OrganizationCoastal Concierge Physical Therapy LlcPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4213 Marblewood Ln, Jacksonville, FL 32216-3614(330) 704-8907PECOS EnrollmentBased on the most recent information from CMS, provider Coastal Concierge Physical Therapy Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1609483361Provider TypeOrganizationFull NameCoastal Concierge Physical Therapy LlcSubpartNoEnumeration Date9/28/2020Last Updated9/28/2020Contact InformationPractice LocationPractice Address4213 Marblewood Ln, Jacksonville, FL 32216-3614Phone(330) 704-8907FaxUnlisted FaxMailing LocationMailing Address4213 Marblewood Ln, Jacksonville, FL 32216-3614Phone(330) 704-8907FaxUnlisted FaxAuthorized OfficialNameBrown, Dana (Sole Mbr)Phone(330) 704-8907Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer