Healthcare Provider Details

I. General information

NPI: 1659335248
Provider Name (Legal Business Name): VERONICA PATRICIA COLLINGS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 16TH AVE N.W. STE 128
SURFSIDE BEACH SC
29575-5285
US

IV. Provider business mailing address

1413 HIGHWAY 17 SOUTH # 182
SURFSIDE BEACH SC
29575-6040
US

V. Phone/Fax

Practice location:
  • Phone: 610-564-0861
  • Fax:
Mailing address:
  • Phone: 610-564-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2679
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-006355-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: