Individual
MARY DIANE COLLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
204 LUDS WAY, DOTHAN, AL 36303-6350
(334) 678-7036
(334) 702-4208
Mailing address
204 LUDS WAY, DOTHAN, AL 36303-6350
(334) 678-7036
(334) 702-4208
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
190
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1281950001
DMERC, PALMETTO GOVERNMEN
AL
01
—
77827
BCBS
AL
Enumeration date
11/07/2005
Last updated
09/08/2015
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