Healthcare Provider Details

I. General information

NPI: 1487651055
Provider Name (Legal Business Name): POPI J. GIANAKOURAS MSPT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 S MAIN ST
HAVERHILL MA
01835-8721
US

IV. Provider business mailing address

790 DALE ST
NORTH ANDOVER MA
01845-1420
US

V. Phone/Fax

Practice location:
  • Phone: 978-372-3211
  • Fax:
Mailing address:
  • Phone: 978-372-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11866
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: