Individual
TAMARA PROCHORCHIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 VALENTINE WAY, SANTA FE, NM 87507-7301
(505) 428-8784
Mailing address
6601 VALENTINE WAY, SANTA FE, NM 87507-7301
(505) 428-8784
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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