Individual
THOMAS RUSSELL GEISENHEIMER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
315 S OSTEOPATHY AVE, KIRKSVILLE, MO 63501-6401
(660) 785-1400
Mailing address
810 KINGS RD APT 2, KIRKSVILLE, MO 63501-2571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014021962
MO
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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