Individual
JIMMY KAKOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT. CSCS
Contact information
Practice address
81 SHREWSBURY ST STE 1, BOYLSTON, MA 01505-1701
(774) 614-1322
(774) 614-1171
Mailing address
84 BARRY RD, WORCESTER, MA 01609-1136
(239) 209-0320
(239) 209-0320
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18231
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18231
STATE LICENSE
MA
Enumeration date
05/24/2007
Last updated
05/13/2026
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