Provider Demographics
NPI:1376176057
Name:SMAY, COLLIN DEAN (DPT)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:DEAN
Last Name:SMAY
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 1:98-1005 MOANALUA RD
Mailing Address - Street 2:SPC 410
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4702
Mailing Address - Country:US
Mailing Address - Phone:808-488-5555
Mailing Address - Fax:
Practice Address - Street 1:1601 UNION AVE STE D
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2133
Practice Address - Country:US
Practice Address - Phone:724-224-5090
Practice Address - Fax:724-224-5093
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5021208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation