Provider Demographics
NPI:1508491259
Name:BROADSTONE CHIROPRACTIC COLLINS, INC.
Entity Type:Organization
Organization Name:BROADSTONE CHIROPRACTIC COLLINS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-983-7771
Mailing Address - Street 1:1837 IRON POINT RD STE 140
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8781
Mailing Address - Country:US
Mailing Address - Phone:916-983-7771
Mailing Address - Fax:916-983-7996
Practice Address - Street 1:1837 IRON POINT RD STE 140
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8781
Practice Address - Country:US
Practice Address - Phone:916-983-7771
Practice Address - Fax:916-983-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty