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General NPI Number Information
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NPI Number | 1750462503
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Entity Type | Organization
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Legal Business Name | COLLINS CHIROPRACTIC INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 09/18/2017
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Provider Practice Location Address
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Address Line | 555 4TH ST STE 1
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City | CLOVIS
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State | CA
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Zip | 93612-1192
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Country | US
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Telephone | 559-323-5000
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Fax | 559-323-5525
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Provider Business Mailing Address
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Address Line | 555 4TH STREET STE 1
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City | CLOVIS
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State | CA
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Zip | 93612
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Country | US
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Telephone | 559-323-5000
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Fax | 559-323-5525
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. VICTOR JAY COLLINS
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Credential | D.C.
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Telephone | 559-323-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC21924
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC21924
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License Number State | CA
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