MEDICARE: MICHAEL EDWARD COLLINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT006035-L	PA

General Provider Information

NPI Number	:	1265480214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL EDWARD COLLINS

Provider Business Mailing Address
First Line	:	1502 W CHESTER PIKE
Second Line	:	NOVACARE
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7705
Country	:	US
Telephone Number	:	610-692-7298
Fax Number	:	610-692-6865

Provider Business Practice Location Address
First Line	:	1502 W CHESTER PIKE
Second Line	:	NOVACARE
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7705
Country	:	US
Telephone Number	:	610-692-7298
Fax Number	:	610-692-6865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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