Healthcare Provider Details

I. General information

NPI: 1700849320
Provider Name (Legal Business Name): MICHAEL B COLLINS DC PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 E WILLIAMS FIELD RD SUITE 105
GILBERT AZ
85295-1692
US

IV. Provider business mailing address

1451 E WILLIAMS FIELD RD SUITE 105
GILBERT AZ
85295-1692
US

V. Phone/Fax

Practice location:
  • Phone: 480-598-0988
  • Fax: 480-753-9611
Mailing address:
  • Phone: 480-598-0988
  • Fax: 480-753-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberAZ7177
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHAEL B COLLINS
Title or Position: PROVIDER
Credential: DC
Phone: 480-598-0988