MEDICARE: MR. JOSHUA KOLLMAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P17575	NC
2	111N00000X	Chiropractor	3687	NC

General Provider Information

NPI Number	:	1245379445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA KOLLMAN D.C.

Provider Business Mailing Address
First Line	:	4300 PARK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-2271
Country	:	US
Telephone Number	:	704-527-7246
Fax Number	:	704-527-3080

Provider Business Practice Location Address
First Line	:	8912 BLAKENEY PROFESSIONAL DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-6735
Country	:	US
Telephone Number	:	704-544-5353
Fax Number	:	704-544-5382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/10/2025

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