Individual
MR. GEOFFREY GAINES KERGOSIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
833 HIGHWAY 90, SUITE 2, BAY ST LOUIS, MS 39520-1601
(228) 463-9030
(228) 463-0103
Mailing address
2167 MITTEER DR, BAY ST LOUIS, MS 39520-8905
(228) 466-5679
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0701
MS
Other
Enumeration date
12/31/2006
Last updated
07/08/2007
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