Organization
ONE SOURCE OF THE GULF COAST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM K. WADE (V.P.)
(228) 875-3828
Entity
Organization
Contact information
Practice address
1903 SPRING HILL AVE, MOBILE, AL 36607-2303
(251) 459-8600
(251) 459-8601
Mailing address
3004 BIENVILLE BLVD STE 1, OCEAN SPRINGS, MS 39564-4370
(228) 875-3828
(228) 436-3580
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/15/2017
Last updated
07/30/2024
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