GULF COAST BRAIN SPORT & SPINE LLC

COVINGTON, LA
NPI1699055475
Entity TypeOrganization
Authorized ContactBEAU J BAGLEY
Owner
504-237-1430
Organization Subpart ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: LA  14743R)
Enumeration Date2011-08-24
Last Update Date2013-03-30
Business Address
GULF COAST BRAIN SPORT & SPINE LLC
1331 OCHSNER BLVD SUITE 100
COVINGTON, LA 70433-8177
Phone number: 985-234-0490
Mailing Address
GULF COAST BRAIN SPORT & SPINE LLC
PO BOX 2013
MANDEVILLE, LA 70470-2013
Phone number: 504-237-1430