Individual
KEN J GAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
117 EAST AVE S, HOLLANDALE, MS 38748-3811
(601) 624-0350
(601) 661-8457
Mailing address
1 W CAMPBELL AVE, APT 1119, PHOENIX, AZ 85013-2998
(601) 624-0350
(601) 661-8457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3460
MS
Other
Enumeration date
05/13/2011
Last updated
03/08/2021
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