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General NPI Number Information
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NPI Number | 1770604266
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Entity Type | Individual
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Provider Name | KIERAN MICHAEL COLLINS D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 157 PROSPECT ST
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City | PASSAIC
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State | NJ
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Zip | 07055-5128
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Country | US
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Telephone | 973-779-4600
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Fax | 973-779-6643
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Provider Business Mailing Address
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Address Line | 157 PROSPECT ST
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City | PASSAIC
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State | NJ
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Zip | 07055-5128
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Country | US
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Telephone | 973-779-4600
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Fax | 973-779-6643
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00543900
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License Number State | NJ
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