Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104556501 | VA |
NPI | 1003984337 |
---|---|
Provider Name | Lori A. Collins |
First Address | Richlands, VA 24641-1045 |
Second Address | Richlands, VA 24641-2346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 03/05/2012 |