Organization
GULFPORT MEDICAL WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVA HALL (OWNER)
(251) 330-8220
Entity
Organization
Contact information
Practice address
12337 ASHLEY DR, SUITE F, GULFPORT, MS 39503-2753
(251) 330-8220
Mailing address
12337 ASHLEY DR, SUITE F, GULFPORT, MS 39503-2753
(251) 330-8220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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