Provider Demographics
NPI:1770758690
Name:DANIEL L COLLINS DC PC
Entity type:Organization
Organization Name:DANIEL L COLLINS DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-261-7000
Mailing Address - Street 1:29671 6 MILE RD
Mailing Address - Street 2:ST 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:ST 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDC006966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OH253020OtherBCBSM
MI95OH253020OtherBCBSM
MIOF35491Medicare PIN