Healthcare Provider Details

I. General information

NPI: 1689672818
Provider Name (Legal Business Name): SEAN MICHAEL COLLINS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 SMALLWOOD DR
RALEIGH NC
27605-1334
US

IV. Provider business mailing address

906 MEBANE OAKS RD
MEBANE NC
27302-7951
US

V. Phone/Fax

Practice location:
  • Phone: 919-301-8267
  • Fax: 919-758-8266
Mailing address:
  • Phone: 919-563-1825
  • Fax: 919-563-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001979E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24115
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: