Provider Demographics
NPI:1073789830
Name:COLAN, MIGUEL ANGEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:COLAN
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 1:360 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1837
Mailing Address - Country:US
Mailing Address - Phone:860-241-0448
Mailing Address - Fax:860-241-0377
Practice Address - Street 1:360 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1837
Practice Address - Country:US
Practice Address - Phone:860-241-0448
Practice Address - Fax:860-241-0377
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor