Healthcare Provider Details

I. General information

NPI: 1871306936
Provider Name (Legal Business Name): GULF COAST CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28260 US HIGHWAY 98 STE B
DAPHNE AL
36526-7075
US

IV. Provider business mailing address

28260 US HIGHWAY 98 STE B
DAPHNE AL
36526-7075
US

V. Phone/Fax

Practice location:
  • Phone: 251-850-4128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KATELYN MANGELS
Title or Position: OWNER/DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 251-850-4128