Individual
MR. COSTAS ACHILLES PAPANICOLAOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3720 PRAIRIE ROSE RD, POPLAR BLUFF, MO 63901-9303
(573) 785-5087
Mailing address
3720 PRAIRIE ROSE LANE, POPLAR BLUFF, MO 63901-9303
(573) 686-5982
(573) 727-2484
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
112211
MO
Other
Enumeration date
06/19/2006
Last updated
07/08/2007
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