Healthcare Provider Details

I. General information

NPI: 1912984345
Provider Name (Legal Business Name): BARBARA J COLLINS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: BOBBIE J COLLINS P.T.

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655A OLD COURT RD SUITE 7
PIKESVILLE MD
21208-3959
US

IV. Provider business mailing address

3655A OLD COURT RD SUITE 7
PIKESVILLE MD
21208-3959
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-9461
  • Fax: 410-486-1376
Mailing address:
  • Phone: 410-486-9461
  • Fax: 410-486-1376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15111
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: