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Organization
COAST NERVE & SPINE CENTER, LLC
Active
Organization
COAST NERVE & SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY PEPPER JR. DC (OWNER/MEMBER)
(228) 831-5554
Entity
Organization
Contact information
Practice address
15037 DEDEAUX RD, GULFPORT, MS 39503-3284
(228) 831-5554
(228) 831-5505
Mailing address
PO BOX 3853, GULFPORT, MS 39505-3853
(228) 831-5554
(228) 831-5505
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0866
MS
Other
Enumeration date
07/09/2008
Last updated
06/03/2013
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