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General NPI Number Information
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NPI Number | 1639308778
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Entity Type | Individual
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Provider Name | MIRANDA A COLLINS O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 935 HIGHWAY 11 S
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City | SWEETWATER
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State | TN
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Zip | 37874-5730
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Country | US
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Telephone | 423-920-2262
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Fax | 423-558-3213
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | SWEETWATER
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State | TN
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Zip | 37874-0129
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Country | US
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Telephone | 423-920-2262
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Fax | 423-558-3213
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3657
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License Number State | TN
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