Individual
GEORGE NIKOLAOS STAVROULAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1644 CARNAHAN DR, GRANTS PASS, OR 97527-4724
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 467-2373
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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