Gulfport Wellness Center INC
NPI #1881134740 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1881134740
- Entity Type
- Organization
- Organization Name
- Gulfport Wellness Center INC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Feb 26, 2017
- Last Updated
- Feb 26, 2017
Practice Location
- Address
- 12261 HIGHWAY 49
- Address 2
- SUITE 6
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39503-2975
- Phone
- (228) 206-0542
Authorized Official
- Name
- MR. MATTHEW JOSEPH SHANNON
- Title
- PRESIDENT/CFO
- Phone
- (501) 339-6067
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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