Individual
JACK T BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 1ST ST, GILROY, CA 95020-5129
(408) 847-6730
(408) 847-6736
Mailing address
190 1ST ST, GILROY, CA 95020-5129
(408) 847-6730
(408) 847-6736
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
21176
CA
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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