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General NPI Number Information
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NPI Number | 1609153022
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Entity Type | Organization
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Legal Business Name | EAST BAY CHIROPRACTIC HEALTH CENTER DR COLLINS INC
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 2574 APPIAN WAY
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City | PINOLE
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State | CA
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Zip | 94564-2237
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Country | US
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Telephone | 510-243-2425
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Fax | 510-243-2428
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Provider Business Mailing Address
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Address Line | 2574 APPIAN WAY
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City | PINOLE
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State | CA
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Zip | 94564-2237
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Country | US
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Telephone | 510-243-2425
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Fax | 510-243-2428
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Authorized Official
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Title or Position | CEO
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Name | SUSAN E KNAPP
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Credential |
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Telephone | 510-243-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC0242640
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License Number State | CA
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