Provider Demographics
NPI:1265968838
Name:COLLINS, JULIE LIVINGSTON (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LIVINGSTON
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:PO BOX 927
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-0927
Mailing Address - Country:US
Mailing Address - Phone:803-490-7945
Mailing Address - Fax:803-808-0909
Practice Address - Street 1:607A S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3430
Practice Address - Country:US
Practice Address - Phone:803-490-7945
Practice Address - Fax:803-808-0909
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor