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Individual

ANDRELLITA B CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1241 9TH STREET, LAS VEGAS, NM 87701
(505) 507-6034
Mailing address
HC 33 102A, LAS VEGAS, NM 87701
(505) 507-6034

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
397
NM

Other

Enumeration date
03/26/2008
Last updated
03/26/2008
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