NPI 1073126132

Coastal Hair Loss Center

Organisation Prosthetist Gulfport, MS

Practice location

Address: 828 Pass Rd STE C, Gulfport, MS 39501-6437
Phone: (228) 617-0908
Mailing address: 1000 34th St APT 3d, Gulfport, MS 39501-6318

Authorised official

Name: Denisha L Williams
Title: Ceo
Phone: (228) 617-0908

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1073126132
Entity type: Organization
NPI issued: 28 Aug 2020
Record last updated: 30 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.