Provider Demographics
NPI:1740376235
Name:COLLINS, MICHELLE L (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1641
Mailing Address - Country:US
Mailing Address - Phone:614-819-1000
Mailing Address - Fax:614-819-1001
Practice Address - Street 1:5017 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1641
Practice Address - Country:US
Practice Address - Phone:614-819-1000
Practice Address - Fax:614-819-1001
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT8460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4309771Medicare Oscar/Certification