Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 909 | CT |
NPI | 1689627929 |
---|---|
Provider Name | Dr. Patricia A. Collins |
First Address | Bridgeport, CT 06606-1820 |
Second Address | Bridgeport, CT 06606-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 14/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004136182 | (05) | CT |
U28427 | (02) | CT |