Provider Demographics
NPI:1154215259
Name:COLLIER, OTIS JR (MA)
Entity type:Individual
Prefix:MR
First Name:OTIS
Middle Name:
Last Name:COLLIER
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2366
Mailing Address - Country:US
Mailing Address - Phone:347-585-1310
Mailing Address - Fax:
Practice Address - Street 1:75 DRAKE RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2366
Practice Address - Country:US
Practice Address - Phone:347-585-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist