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General NPI Number Information
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NPI Number | 1811813173
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Entity Type | Individual
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Provider Name | MICHELE MCCOLLUM
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Gender | Female
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 2201 CIVIC CIR STE 908
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City | AMARILLO
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State | TX
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Zip | 79109-1847
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Country | US
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Telephone | 806-686-0429
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Fax |
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Provider Business Mailing Address
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Address Line | 8402 WHITTIER DR
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City | AMARILLO
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State | TX
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Zip | 79110-4928
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Country | US
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Telephone | 806-282-4523
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2016002
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License Number State | TX
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