Provider Demographics
NPI:1235143728
Name:COLLIER, JAMES LEWIS (RT ARRT MA BS AS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEWIS
Last Name:COLLIER
Suffix:
Gender:M
Credentials:RT ARRT MA BS AS
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Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:LAPWAI
Mailing Address - State:ID
Mailing Address - Zip Code:83540-0367
Mailing Address - Country:US
Mailing Address - Phone:208-843-2271
Mailing Address - Fax:208-843-2658
Practice Address - Street 1:111 BEVER GRADE
Practice Address - Street 2:
Practice Address - City:LAPWAI
Practice Address - State:ID
Practice Address - Zip Code:83540
Practice Address - Country:US
Practice Address - Phone:208-843-2271
Practice Address - Fax:208-843-2658
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID396088 ARRT247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist