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General NPI Number Information
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NPI Number | 1598847592
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Entity Type | Organization
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Legal Business Name | GULF COAST PHYSICAL THERAPY CENTERS PA
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 BEAUVOIR RD STE 5
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City | BILOXI
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State | MS
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Zip | 39531-4026
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Country | US
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Telephone | 228-223-6142
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 45TH AVE STE B
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City | GULFPORT
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State | MS
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Zip | 39501-3714
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Country | US
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Telephone | 228-864-1212
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Fax | 228-868-2323
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. MICHAEL N PHILLIPS
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Credential | PT
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Telephone | 228-864-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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