Organization
GULF COAST LASER WEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS GLEASON (CEO)
(520) 323-8732
Entity
Organization
Contact information
Practice address
800 OCALA RD, #300-346, TALLAHASSEE, FL 32304-1669
(520) 547-4130
(520) 258-0304
Mailing address
6339 E SPEEDWAY BLVD, SUITE 201, TUCSON, AZ 85710-1147
(520) 323-8732
(520) 547-1865
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/31/2008
Last updated
06/04/2008
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