Provider Demographics
NPI:1609094598
Name:COLLINS, DAVID F (CERTIFIED ORTHOTIST)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:F
Last Name:COLLINS
Suffix:
Gender:M
Credentials:CERTIFIED ORTHOTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2856
Mailing Address - Country:US
Mailing Address - Phone:252-413-0409
Mailing Address - Fax:252-413-0423
Practice Address - Street 1:657 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2856
Practice Address - Country:US
Practice Address - Phone:252-413-0409
Practice Address - Fax:252-413-0423
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795289Medicaid
NC7795289Medicaid