Provider Demographics
NPI:1649876525
Name:PRECOUR, COLLIN
Entity type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:
Last Name:PRECOUR
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:N9691 HWY 13
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555-7771
Mailing Address - Country:US
Mailing Address - Phone:715-339-2052
Mailing Address - Fax:715-748-6304
Practice Address - Street 1:N9691 HIGHWAY 13 NORTH
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:WI
Practice Address - Zip Code:54555-5455
Practice Address - Country:US
Practice Address - Phone:715-339-2052
Practice Address - Fax:715-748-6304
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5586-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor