Provider Demographics
NPI:1467671974
Name:COLLIER, PATTI B
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:B
Last Name:COLLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 LOCKHART RD
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-7071
Mailing Address - Country:US
Mailing Address - Phone:256-773-8622
Mailing Address - Fax:
Practice Address - Street 1:1606 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5313
Practice Address - Country:US
Practice Address - Phone:256-739-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL11771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist