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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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