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Individual

NICHOLAS COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
16888 NISQUALLI RD STE 240, VICTORVILLE, CA 92395-9703
(760) 936-9897
(760) 980-2589
Mailing address
16888 NISQUALLI RD STE 240, VICTORVILLE, CA 92395-9703
(760) 936-9897
(760) 980-2589

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
000599-2022
CA

Other

Enumeration date
04/28/2022
Last updated
04/28/2022
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