Provider Demographics
NPI:1942754742
Name:ATKINSON, COLLIN THOMAS (PT)
Entity Type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:THOMAS
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 UPLAND ST
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-8026
Mailing Address - Country:US
Mailing Address - Phone:907-335-7513
Mailing Address - Fax:888-491-3360
Practice Address - Street 1:11724 SEWARD HWY
Practice Address - Street 2:SUITE G
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-9708
Practice Address - Country:US
Practice Address - Phone:907-224-7848
Practice Address - Fax:907-224-7849
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60670784225100000X
AK114699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist