Provider Demographics
NPI:1417980319
Name:COLLINS, DANIEL B (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:COLLINS
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 1:395 BAY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1405
Mailing Address - Country:US
Mailing Address - Phone:518-743-0491
Mailing Address - Fax:518-793-1515
Practice Address - Street 1:395 BAY RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1405
Practice Address - Country:US
Practice Address - Phone:518-743-0491
Practice Address - Fax:518-793-1515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009482-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
BB8458Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION N