Individual
KENNETH RICHARD GEURTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
INDEPENDENT DUTY COR
Contact information
Practice address
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9007
(228) 871-2810
Mailing address
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9007
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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