Individual ProviderColin O'ConnorStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(623) 848-5612PECOS EnrollmentBased on the most recent information from CMS, provider Colin O'Connor does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1568099901Provider TypeIndividualFull NameO'Connor, ColinGenderMaleSole ProprietorYesEnumeration Date3/25/2020Last Updated3/25/2020Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(623) 848-5612FaxUnlisted FaxMailing LocationMailing Address7302 E Valley Vista Dr, Scottsdale, AZ 85250-5517PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer