Provider Demographics
NPI:1609093350
Name:O'COLLINS, TERRENCE PATRAIC (DC)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:PATRAIC
Last Name:O'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 1:1735 MINNEWAWA AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2567
Mailing Address - Country:US
Mailing Address - Phone:559-324-1500
Mailing Address - Fax:
Practice Address - Street 1:1735 MINNEWAWA AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2567
Practice Address - Country:US
Practice Address - Phone:559-324-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor