Provider Demographics
NPI:1619469459
Name:COLLINS, BARRY SEAN (PTA)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:SEAN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENESIS DUNBAR CENTER
Mailing Address - Street 2:501 CALDWELL LANE
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-2026
Mailing Address - Country:US
Mailing Address - Phone:304-744-4761
Mailing Address - Fax:304-744-6544
Practice Address - Street 1:GENESIS DUNBAR CENTER
Practice Address - Street 2:501 CALDWELL LANE
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2026
Practice Address - Country:US
Practice Address - Phone:304-744-4761
Practice Address - Fax:304-744-6544
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant