Provider Demographics
NPI:1992856454
Name:COLLINS, PATRICK J (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name: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 1:6126 SW 26TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-8235
Mailing Address - Country:US
Mailing Address - Phone:719-622-1352
Mailing Address - Fax:
Practice Address - Street 1:117 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3801
Practice Address - Country:US
Practice Address - Phone:719-622-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5413111N00000X
KS01-05249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU93606Medicare UPIN
CO484298Medicare PIN