Provider Demographics
NPI:1720172562
Name:COLLINS, DANIEL L (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
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 1:29671 6 MILE RD
Mailing Address - Street 2:STE 110 C
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-4555
Mailing Address - Country:US
Mailing Address - Phone:734-261-7000
Mailing Address - Fax:734-261-7001
Practice Address - Street 1:29671 6 MILE RD
Practice Address - Street 2:STE 110 C
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-4555
Practice Address - Country:US
Practice Address - Phone:734-261-7000
Practice Address - Fax:734-261-7001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDC006966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OH253020OtherBCBSM
MIU49174Medicare UPIN
MIOF35491Medicare PIN