Individual
ANDREW BLAKE COLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-5400
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4662
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2023046522
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212511-00
—
FL
01
—
HRE4P
MCR
FL
Enumeration date
07/24/2007
Last updated
12/21/2023
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