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General NPI Number Information
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NPI Number | 1336452598
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Entity Type | Individual
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Provider Name | AMANDA COLLINS LMT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 4801 34TH STREET
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City | LUBBOCK
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State | TX
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Zip | 79410
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Country | US
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Telephone | 806-368-2182
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Fax | 806-793-4430
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Provider Business Mailing Address
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Address Line | 5310 47TH ST
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City | LUBBOCK
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State | TX
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Zip | 79414-1518
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Country | US
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Telephone | 806-793-4430
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Fax | 806-793-4430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MT046258
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License Number State | TX
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