Individual
JOHN SOUKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MTC
Contact information
Practice address
1650 THOMPSON RD, COOS BAY, OR 97420-2170
(541) 269-7212
(541) 267-5260
Mailing address
1650 THOMPSON RD, COOS BAY, OR 97420-2170
(541) 269-7212
(541) 267-5260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6090
OR
Other
Enumeration date
06/14/2006
Last updated
10/19/2009
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