Provider Demographics
NPI:1962446286
Name:VERONICA COLLINGS, INC
Entity Type:Organization
Organization Name:VERONICA COLLINGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:COLLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:105-640-8616
Mailing Address - Street 1:1413 HIGHWAY 17 S # 182
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-6040
Mailing Address - Country:US
Mailing Address - Phone:610-564-0861
Mailing Address - Fax:
Practice Address - Street 1:1012 16TH AVE NW STE 128
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-5285
Practice Address - Country:US
Practice Address - Phone:610-564-0861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962446286Medicare PIN
PAU57564Medicare UPIN