Asa LLC
NPI #1558897744 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1558897744
- Entity Type
- Organization
- Organization Name
- Asa LLC
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- May 7, 2017
- Last Updated
- May 7, 2017
Practice Location
- Address
- 1924 30TH AVE
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39501-4534
- Phone
- (228) 343-3044
Authorized Official
- Name
- MR. ROBERT LEE GILLUM JR.
- Title
- SURGICAL ASSISTANT
- Phone
- (228) 343-3044
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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