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General NPI Number Information
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NPI Number | 1144409277
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Entity Type | Organization
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Legal Business Name | GULF COAST CHIROPRACTIC
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 2855 EASTEX FWY SUITE E
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City | BEAUMONT
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State | TX
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Zip | 77706-3065
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Country | US
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Telephone | 409-899-2300
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Fax | 409-898-2273
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Provider Business Mailing Address
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Address Line | 2855 EASTEX FWY SUITE E
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City | BEAUMONT
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State | TX
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Zip | 77706-3065
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Country | US
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Telephone | 409-899-2300
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Fax | 409-898-2273
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ASHLEY ELIZABETH MONTALBANO
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Credential |
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Telephone | 409-899-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC4793
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License Number State | TX
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