MEDICARE: DR. RICHARD LEE COLLIN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR007907	GA

General Provider Information

NPI Number	:	1790954360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD LEE COLLIN D.C.

Provider Business Mailing Address
First Line	:	245 PEACHTREE INDUSTRIAL BLVD
Second Line	:
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-9126
Country	:	US
Telephone Number	:	770-831-1155
Fax Number	:	770-831-0250

Provider Business Practice Location Address
First Line	:	245 PEACHTREE INDUSTRIAL BLVD
Second Line	:
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-9126
Country	:	US
Telephone Number	:	770-831-1155
Fax Number	:	770-831-0250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	08/31/2015

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