MEDICARE: DR. FRANCIS RICHARD COLLURA 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	DC007563L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	669657	OTHER	PA	BLUE SHIELD NUMBER

General Provider Information

NPI Number	:	1952366866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS RICHARD COLLURA D.C.

Provider Business Mailing Address
First Line	:	220 CHURCH ST
Second Line	:
City	:	JESSUP
State	:	PA
Zip	:	18434-1049
Country	:	US
Telephone Number	:	570-383-4800
Fax Number	:	570-291-0064

Provider Business Practice Location Address
First Line	:	220 CHURCH ST
Second Line	:
City	:	JESSUP
State	:	PA
Zip	:	18434-1049
Country	:	US
Telephone Number	:	570-383-4800
Fax Number	:	570-291-0064

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	03/17/2016

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