Provider Demographics
NPI:1235015231
Name:COLLINS, CLINTON STUART (DC)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:STUART
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 OVERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3932
Mailing Address - Country:US
Mailing Address - Phone:386-846-0692
Mailing Address - Fax:
Practice Address - Street 1:1102 OVERBROOK DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3932
Practice Address - Country:US
Practice Address - Phone:386-846-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor