Doctor Name: | GRANT MICHAEL COLLINS |
NPI Number: | 1457679730 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 2008020468 |
Business Practice Address: | 2166 North Westwood Blvd Poplar Bluff, MO - 639012440 |
Business Phone Number: | 5737122696 |
Business Fax Number: | 5737122991 |
Mailing Address: | 2166 North Westwood Blvd, POPLAR BLUFF |
State: | MO |
Postal Code: | 639012440 |
Phone Number: | 5737122696 |
Fax Number: | 5737122991 |
NPI Enumeration Date: | 05/11/2010 |
NPI Last Update Date: | 04/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2008020468 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |