Provider Demographics
NPI:1922004167
Name:KOLLAR, CHRISTIAN JON (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JON
Last Name:KOLLAR
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 1:2216 COUNTY ROAD D W STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-8505
Mailing Address - Country:US
Mailing Address - Phone:651-636-4120
Mailing Address - Fax:651-639-1069
Practice Address - Street 1:2216 COUNTY ROAD D W STE B
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-8505
Practice Address - Country:US
Practice Address - Phone:651-636-4120
Practice Address - Fax:651-639-1069
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350002907Medicare ID - Type Unspecified
MNU95804Medicare UPIN