Organization
PASS CHRISTIAN CHIROMED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE PAUL BOURGEIOS III DC (PHYSICIAN)
(228) 865-9898
Entity
Organization
Contact information
Practice address
213 HENDERSON AVE, PASS CHRISTIAN, MS 39571-4309
(228) 865-9898
(228) 863-5616
Mailing address
PO BOX 2563, GULFPORT, MS 39505-2563
(228) 865-9898
(228) 863-5616
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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