| Gulfport Premier Aba Llc | |
|
928 Courthouse Rd Unit 3 Gulfport MS 39507-4110 | |
| (228) 229-8297 | |
| Not Available |
| Full Name | Gulfport Premier Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 928 Courthouse Rd Unit 3, Gulfport, Mississippi |
| Authorized Official Name and Position | Gregory Stanford (CO-OWNER) |
| Authorized Official Contact | 2282298297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulfport Premier Aba Llc 928 Courthouse Rd Unit 3 Gulfport MS 39507-4110 Ph: (228) 229-8297 | Gulfport Premier Aba Llc 928 Courthouse Rd Unit 3 Gulfport MS 39507-4110 Ph: (228) 229-8297 |
| NPI Number | 1285239590 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Certification Date | 12/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285239590 | NPI | - | NPPES |
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