Healthcare Provider Details

I. General information

NPI: 1457341091
Provider Name (Legal Business Name): THOMAS T KOLLARS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 BEACH ST # 10
WESTERLY RI
02891-2739
US

IV. Provider business mailing address

203 E 3RD ST
LANDSDALE PA
19446
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-3493
  • Fax:
Mailing address:
  • Phone: 860-326-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003642L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDCP00571
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number001713
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: