Provider Demographics
NPI:1558786525
Name:COLLINS, LAUREN (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:COLLINS
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 1:4539 SE HALSTON CT
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-2462
Mailing Address - Country:US
Mailing Address - Phone:904-334-6962
Mailing Address - Fax:
Practice Address - Street 1:4539 SE HALSTON CT
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-2462
Practice Address - Country:US
Practice Address - Phone:904-334-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC 1265111N00000X
FLCH11556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor