Gulf Coast Neurospa LLC
NPI #1013515451 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1013515451
- Entity Type
- Organization
- Organization Name
- Gulf Coast Neurospa LLC
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Oct 16, 2020
- Last Updated
- Apr 25, 2023
Practice Location
- Address
- 8845 LORRAINE ROAD
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39503
- Phone
- (228) 277-1771
Authorized Official
- Name
- BRYAN VYVERBERG, MD
- Title
- OWNER
- Phone
- (228) 277-1771
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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