Provider Demographics
NPI:1841084647
Name:O'LEARY, COLIN THOMAS (DC)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:THOMAS
Last Name:O'LEARY
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 1:700 SPRING FALLS DR APT 411
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-9162
Mailing Address - Country:US
Mailing Address - Phone:585-690-9963
Mailing Address - Fax:
Practice Address - Street 1:309 W MILLBROOK RD STE 199
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4394
Practice Address - Country:US
Practice Address - Phone:919-788-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor