Provider Demographics
NPI:1972532430
Name:COLLINS, TERRY LYNN (MS, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LYNN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LINCOLN AVE.
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47722-0001
Mailing Address - Country:US
Mailing Address - Phone:812-488-2091
Mailing Address - Fax:812-488-2199
Practice Address - Street 1:1800 LINCOLN AVE.
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47722-0001
Practice Address - Country:US
Practice Address - Phone:812-488-2091
Practice Address - Fax:812-488-2199
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer