Provider Demographics
NPI:1598188161
Name:COLLIER, MARTIN CHRISTOPHER (DC)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:CHRISTOPHER
Last Name:COLLIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:M. CHRIS
Other - Middle Name:
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:18118 CHESTERFIELD AIRPORT RD STE F
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1124
Mailing Address - Country:US
Mailing Address - Phone:636-728-8607
Mailing Address - Fax:314-400-2204
Practice Address - Street 1:18118 CHESTERFIELD AIRPORT RD STE F
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1124
Practice Address - Country:US
Practice Address - Phone:636-728-8607
Practice Address - Fax:314-400-2204
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014002436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4897001Medicare PIN