Healthcare Provider Details
I. General information
NPI: 1245379445
Provider Name (Legal Business Name): JOSHUA KOLLMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/05/2007
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8912 BLAKENEY PROFESSIONAL DR STE 100
CHARLOTTE NC
28277-6735
US
IV. Provider business mailing address
4300 PARK RD
CHARLOTTE NC
28209-2271
US
V. Phone/Fax
- Phone: 704-544-5353
- Fax: 704-544-5382
- Phone: 704-527-7246
- Fax: 704-527-3080
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | P17575 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3687 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: