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Individual
BENJAMIN JOHN KAKALLIS
Active
Individual
BENJAMIN JOHN KAKALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0013968
CO
Other
Enumeration date
10/06/2019
Last updated
10/06/2019
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