Provider Demographics
NPI:1639283393
Name:COLLINS, AMY KATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KATHERINE
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 1:6 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:GRISWOLD
Mailing Address - State:CT
Mailing Address - Zip Code:06351-9121
Mailing Address - Country:US
Mailing Address - Phone:860-303-6463
Mailing Address - Fax:
Practice Address - Street 1:6 LYNN DR
Practice Address - Street 2:
Practice Address - City:GRISWOLD
Practice Address - State:CT
Practice Address - Zip Code:06351-9121
Practice Address - Country:US
Practice Address - Phone:860-303-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU89372Medicare UPIN
CT350001252Medicare ID - Type Unspecified