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General NPI Number Information
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NPI Number | 1164023677
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Entity Type | Organization
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Legal Business Name | COLLIER MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 1661 STATE ROUTE 522 UNIT 2
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City | WHEELERSBURG
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State | OH
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Zip | 45694-8120
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Country | US
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Telephone | 740-574-1770
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Fax | 740-574-8781
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Provider Business Mailing Address
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Address Line | 1661 STATE ROUTE 522 UNIT 2
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City | WHEELERSBURG
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State | OH
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Zip | 45694-8120
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Country | US
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Telephone | 740-574-1770
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Fax | 740-574-8781
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Authorized Official
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Title or Position | OWNER
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Name | MARILYN J COLLIER
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Credential |
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Telephone | 740-574-1770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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