NPI 1699055475

Gulf Coast Brain Sport & Spine LLC

Organisation Physical Medicine & Rehabilitation Physician Covington, LA

Practice location

Address: 1331 Ochsner Blvd Suite 100, Covington, LA 70433-8177
Phone: (985) 234-0490
Mailing address: PO Box 2013, Mandeville, LA 70470-2013

Authorised official

Name: Beau J Bagley
Title: Owner
Phone: (504) 237-1430

Registered specialties

Physical Medicine & Rehabilitation Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence 14743R (LA)

Other Physical Medicine & Rehabilitation providers in Louisiana →

Registry record

NPI: 1699055475
Entity type: Organization
NPI issued: 24 Aug 2011
Record last updated: 30 Mar 2013

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.