Provider Demographics
NPI:1053845206
Name:COLLIER, AUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:COLLIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50544 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3134
Mailing Address - Country:US
Mailing Address - Phone:586-532-1448
Mailing Address - Fax:586-532-1472
Practice Address - Street 1:50544 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-3134
Practice Address - Country:US
Practice Address - Phone:586-532-1448
Practice Address - Fax:586-532-1472
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301010506OtherSTATE LICENSE