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General NPI Number Information
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NPI Number | 1730470345
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Entity Type | Individual
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Provider Name | TRACY COLLINS PT, DPT, MS, CNS
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Gender | Female
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 760 CHAMPIONS CLOSE
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City | MILTON
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State | GA
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Zip | 30004-0949
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Country | US
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Telephone | 678-224-8283
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Fax |
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Provider Business Mailing Address
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Address Line | 760 CHAMPIONS CLOSE
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City | MILTON
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State | GA
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Zip | 30004-0949
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Country | US
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Telephone | 678-224-8283
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT011231
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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