=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346513660
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. CURTIS COLLINS, A CHIROPRACTIC CORPERATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2012
-----------------------------------------------------
Last Update Date | 02/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5500 MING AVE STE # 170
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-4689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-836-2226
-----------------------------------------------------
Fax | 661-836-2223
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5500 MING AVE STE # 170
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-836-2226
-----------------------------------------------------
Fax | 661-836-2223
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. CURT W COLLINS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 661-836-2226
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 12 00119415
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------