Provider Demographics
NPI:1699806935
Name:COLLINS, HEATHER B (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:B
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:STINSON
Other - Last Name:BALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1285 HEMBREE RD
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5720
Mailing Address - Country:US
Mailing Address - Phone:770-475-2710
Mailing Address - Fax:770-360-0498
Practice Address - Street 1:1285 HEMBREE RD
Practice Address - Street 2:SUITE 200-A
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5720
Practice Address - Country:US
Practice Address - Phone:770-475-2710
Practice Address - Fax:770-360-0498
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist