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General NPI Number Information
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NPI Number | 1629627146
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Entity Type | Individual
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Provider Name | NOAH JOSEPH COLLIER
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Gender | Male
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 8 HORTON PL
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City | MILTON
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State | MA
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Zip | 02186-4720
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Country | US
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Telephone | 617-653-7141
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Fax |
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Provider Business Mailing Address
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Address Line | 8 HORTON PL
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City | MILTON
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State | MA
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Zip | 02186-4720
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Country | US
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Telephone | 617-653-7141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | S19947702
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License Number State | MA
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