Individual
DAN LOUIS KOLILIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
47754 FOOTHILL RD, HAINES, OR 97833-6403
(541) 403-4863
Mailing address
47754 FOOTHILL RD, HAINES, OR 97833-6403
(541) 403-4863
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
201141129RN
OR
163WH0200X
Home Health Registered Nurse
N-35484
ID
Other
Enumeration date
06/04/2016
Last updated
06/04/2016
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