Organization
GULF COAST REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JOCELYN ALLEEN MAYFIELD MPT, OTR/L (PRESIDENT)
(228) 818-9164
Entity
Organization
Contact information
Practice address
1706 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-3073
(228) 818-9164
(228) 818-9167
Mailing address
PO BOX 605, OCEAN SPRINGS, MS 39566-0605
(228) 818-9164
(228) 818-9167
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT3521
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08635794
—
MS
Enumeration date
07/12/2007
Last updated
07/12/2007
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