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Organization

GULF COAST SPINAL & NEUROSURGICAL SPECIALISTS LLC

Active
Parent organization
GULF COAST SPINAL & NEUROSURGICAL SPECIALISTS LLC
Other names
PHYSICAL THERAPY DEPARTMENT
Organization subpart
Yes

Provider details

NPI number
Legal business name
GULF COAST SPINAL & NEUROSURGICAL SPECIALISTS LLC
Authorized official
MS. MELANIE L FAYARD PT (CLINIC MANAGER)
(228) 875-4000
Entity
Organization

Contact information

Practice address
11010 DAVID ST, SUITE B, GULFPORT, MS 39503-3481
(228) 832-8327
(228) 832-8328
Mailing address
11010 DAVID ST, SUITE B, GULFPORT, MS 39503-3481
(228) 832-8327
(228) 832-8328

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
02/22/2012
Last updated
02/22/2012
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