Individual
JACOB PAPANICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 SE G ST, GRANTS PASS, OR 97526-3066
(541) 476-1583
Mailing address
650 N HASKELL ST, CENTRAL POINT, OR 97502-2592
(707) 396-2759
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64068
OR
Other
Enumeration date
08/16/2025
Last updated
08/16/2025
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