Individual
KELLEY GIANNAKOUROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO3872
Contact information
Practice address
1699 N WOODLAND BLVD, DELAND, FL 32720-1803
(386) 734-6372
Mailing address
1699 N WOODLAND BLVD, DELAND, FL 32720-1803
(386) 734-6372
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3872
FL
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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