Most Relevant Information
Provider Data
| NPI Number: | 1003397068 |
| Provider Name: | MICK GENE COLLIAS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/27/2018 |
| Last Updated: | 08/27/2018 |
Provider Practice Location
1003 COTTONWOOD RD
CRESTON
IA
508011012
Practice Location Phone/Fax
| Phone: | 6417828457 |
| Fax: |
Provider Mailing Location
1301 N ELM ST APT 2
CRESTON
IA
508011140
Provider Mailing Phone/Fax
| Phone: | 6363598140 |
| Fax: |