Provider Demographics
NPI:1164632576
Name:COLLINS, TIA MARIE (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:TIA
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:KS
Mailing Address - Zip Code:66035-4165
Mailing Address - Country:US
Mailing Address - Phone:785-442-6049
Mailing Address - Fax:785-442-6104
Practice Address - Street 1:606 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:KS
Practice Address - Zip Code:66035-4165
Practice Address - Country:US
Practice Address - Phone:785-442-6049
Practice Address - Fax:785-442-6104
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer