Provider Demographics
NPI:1811126287
Name:COLLINS CHIROPRACTIC: A CREATING WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:COLLINS CHIROPRACTIC: A CREATING WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-276-0777
Mailing Address - Street 1:4007 OLD SEWARD HWY
Mailing Address - Street 2:STE. 380
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6075
Mailing Address - Country:US
Mailing Address - Phone:907-276-0777
Mailing Address - Fax:907-770-9192
Practice Address - Street 1:4007 OLD SEWARD HWY
Practice Address - Street 2:STE. 380
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6075
Practice Address - Country:US
Practice Address - Phone:907-276-0777
Practice Address - Fax:907-770-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty