MEDICARE: AMBER KOLLEN DC

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	13017	FL

General Provider Information

NPI Number	:	1962042093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER KOLLEN DC

Provider Business Mailing Address
First Line	:	2445 COUNTRY PLACE BLVD STE 103
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1102
Country	:	US
Telephone Number	:	727-264-6091
Fax Number	:	727-264-6099

Provider Business Practice Location Address
First Line	:	2445 COUNTRY PLACE BLVD STE 103
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1102
Country	:	US
Telephone Number	:	727-264-6091
Fax Number	:	727-264-6099

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

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	12/08/2023

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Directions to “ AMBER KOLLEN DC” Practice Location

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