Provider Demographics
NPI:1790954360
Name:COLLIN, RICHARD LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:COLLIN
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 1:245 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-9126
Mailing Address - Country:US
Mailing Address - Phone:770-831-1155
Mailing Address - Fax:770-831-0250
Practice Address - Street 1:245 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-9126
Practice Address - Country:US
Practice Address - Phone:770-831-1155
Practice Address - Fax:770-831-0250
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35ZCJJNMedicare PIN