Healthcare Provider Details

I. General information

NPI: 1780810366
Provider Name (Legal Business Name): KAREN E COLLINS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 02/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 HARVEST RD
HOLDEN ME
04429-7269
US

IV. Provider business mailing address

170 HARVEST RD
HOLDEN ME
04429-7269
US

V. Phone/Fax

Practice location:
  • Phone: 207-843-6822
  • Fax: 866-220-5031
Mailing address:
  • Phone: 207-843-6822
  • Fax: 866-220-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2271
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier038035
Identifier TypeOTHER
Identifier StateME
Identifier IssuerANTHEM OF MAINE
# 2
IdentifierP00736457
Identifier TypeOTHER
Identifier StateME
Identifier IssuerRR MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: