Provider Demographics
NPI:1376695155
Name:COLLIER, CHRISTIE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:MARIE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 AGATE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92662-1085
Mailing Address - Country:US
Mailing Address - Phone:949-723-0702
Mailing Address - Fax:949-723-0026
Practice Address - Street 1:128 AGATE AVE STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92662-1085
Practice Address - Country:US
Practice Address - Phone:949-723-0702
Practice Address - Fax:949-723-0026
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor