Provider Demographics
NPI:1265723951
Name:COLLINS, MICHAEL BEAU (IOWA LICENSED HEARIN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BEAU
Last Name:COLLINS
Suffix:
Gender:M
Credentials:IOWA LICENSED HEARIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 CENTER POINT ROAD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402
Mailing Address - Country:US
Mailing Address - Phone:319-393-8994
Mailing Address - Fax:319-393-0895
Practice Address - Street 1:3717 CENTER POINT ROAD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-393-8994
Practice Address - Fax:319-393-0895
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001022237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist