Individual
COREY DONOVAN COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
2801 FRANCIS AVE, LEAVENWORTH, KS 66048-4198
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23-49469-052
KS
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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