Provider Demographics
NPI:1093320400
Name:COLLINS, WILLIAM TRAVIS (DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TRAVIS
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DPT
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 1366
Mailing Address - Street 2:
Mailing Address - City:DRAYTON
Mailing Address - State:SC
Mailing Address - Zip Code:29333-0802
Mailing Address - Country:US
Mailing Address - Phone:351-552-0065
Mailing Address - Fax:
Practice Address - Street 1:2 GRIFFITH RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3503
Practice Address - Country:US
Practice Address - Phone:864-990-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC100262251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics