Healthcare Provider Details

I. General information

NPI: 1609094598
Provider Name (Legal Business Name): DAVID F COLLINS CERTIFIED ORTHOTIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 S MEMORIAL DR
GREENVILLE NC
27834-2856
US

IV. Provider business mailing address

657 S MEMORIAL DR
GREENVILLE NC
27834-2856
US

V. Phone/Fax

Practice location:
  • Phone: 252-413-0409
  • Fax: 252-413-0423
Mailing address:
  • Phone: 252-413-0409
  • Fax: 252-413-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: