Provider Demographics
NPI:1346407442
Name:COLLINS, THELMA J (LMT)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 CASS RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3135
Mailing Address - Country:US
Mailing Address - Phone:419-380-2898
Mailing Address - Fax:419-380-2898
Practice Address - Street 1:1865 CASS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3135
Practice Address - Country:US
Practice Address - Phone:419-380-2898
Practice Address - Fax:419-380-2898
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.011836172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH200836238-00OtherBWC
OH33.011836OtherSTATE MEDICAL BOARD