| NPI | 1255625067 |
|---|---|
| Doing Business As | GULF COAST MEDICAL GROUP-CHRONIC PAIN TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2012-11-27 |