Organization
GULF COAST NEUROSPA LLC
Active
Other names
Bridgewater TMS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN VYVERBERG MD (OWNER)
(228) 277-1771
Entity
Organization
Contact information
Practice address
8845 LORRAINE ROAD, GULFPORT, MS 39503
(228) 277-1771
(866) 740-0655
Mailing address
8845 LORRAINE ROAD, GULFPORT, MS 39503
(228) 277-1771
(866) 740-0655
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
04/25/2023
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