Provider Demographics
NPI:1891788204
Name:HUNT, COLLE JR (DC)
Entity type:Individual
Prefix:DR
First Name:COLLE
Middle Name:
Last Name:HUNT
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:460 NAVARO WAY
Mailing Address - Street 2:#102
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2487
Mailing Address - Country:US
Mailing Address - Phone:408-836-5997
Mailing Address - Fax:408-955-0813
Practice Address - Street 1:3151 OLIN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1635
Practice Address - Country:US
Practice Address - Phone:408-247-8812
Practice Address - Fax:408-247-8814
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC293650Medicare UPIN