Individual
MR. MICHAEL J. COLLERAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA, CCC-A
Contact information
Practice address
633 E SIOUX AVE, PIERRE, SD 57501-3368
(605) 224-8848
(605) 224-7870
Mailing address
633 E SIOUX AVE, PIERRE, SD 57501-3368
(605) 224-8848
(605) 224-7870
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
33001460445192EUT001
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58301321
—
SD
Enumeration date
06/30/2005
Last updated
07/09/2007
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