MEDICARE: GULF COAST PHYSICAL THERAPY CENTERS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598847592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF COAST PHYSICAL THERAPY CENTERS PA

Provider Business Mailing Address
First Line	:	1500 45TH AVE STE B
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39501-3714
Country	:	US
Telephone Number	:	228-864-1212
Fax Number	:	228-868-2323

Provider Business Practice Location Address
First Line	:	250 BEAUVOIR RD STE 5
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-4026
Country	:	US
Telephone Number	:	228-223-6142
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	MR. MICHAEL N PHILLIPS
Credential	:	PT
Telephone Number	:	228-864-1212

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/22/2020

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Directions to “GULF COAST PHYSICAL THERAPY CENTERS PA ” Practice Location

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