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General NPI Number Information
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NPI Number | 1366528218
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Entity Type | Individual
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Provider Name | DIANE C COLLINS PT CHT
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 75 BAYLOR DR
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City | BLUFFTON
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State | SC
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Zip | 29910-8965
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Country | US
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Telephone | 843-476-4682
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Fax | 843-949-3022
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Provider Business Mailing Address
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Address Line | 333 E 34TH ST RM 1L
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City | NEW YORK
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State | NY
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Zip | 10016-4956
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Country | US
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Telephone | 212-689-2680
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Fax | 212-689-8050
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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 | 0074061
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11607
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License Number State | SC
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