Provider Demographics
NPI:1336399161
Name:COLLIER, WENDELL
Entity type:Individual
Prefix:MR
First Name:WENDELL
Middle Name:
Last Name:COLLIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-0033
Mailing Address - Country:US
Mailing Address - Phone:614-829-5000
Mailing Address - Fax:
Practice Address - Street 1:8877 BASIL WESTERN RD NW
Practice Address - Street 2:SUITE 255
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9276
Practice Address - Country:US
Practice Address - Phone:614-829-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies