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1245783695
DAVE COLLINS
PORTLAND, OR
NPI
1245783695
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
222Z00000X Orthotist
(Licence: AZ CO002780)
Enumeration Date
2016-08-02
Last Update Date
2016-08-02
Business Address
-- DAVE COLLINS CO002780
3101 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3009
Phone number: 503-221-3430
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Mailing Address
-- DAVE COLLINS CO002780
PO BOX 865109
ORLANDO, FL 32886-5109
Phone number: 503-221-3430
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