Provider Demographics
NPI:1639315799
Name:COLLINS, PATRICIA F (PTA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:F
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-4610
Mailing Address - Country:US
Mailing Address - Phone:918-836-5406
Mailing Address - Fax:918-832-8618
Practice Address - Street 1:1541 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-4610
Practice Address - Country:US
Practice Address - Phone:918-836-5406
Practice Address - Fax:918-832-8618
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK64225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant