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Individual

MR. DIMITRIS KOLLAROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCSS WORKER

Contact information

Practice address
1100 S. MAIN, EXECUTIVE SUITES, LAS CRUCES, NM 88005-2917
(575) 525-5635
(575) 647-8804
Mailing address
106 W ETHEL AVE, LAS CRUCES, NM 88005-1714
(575) 640-3537

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/22/2009
Last updated
05/22/2009
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