MEDICARE: MRS. JOY V. COLLINS P.T.

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	4713	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598716417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOY V. COLLINS P.T.

Provider Business Mailing Address
First Line	:	543 HIGHWAY 17 N
Second Line	:	NORTH BEACH SHOPPING CENTER
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-2903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 HIGHWAY 17 N
Second Line	:	NORTH BEACH SHOPPING CENTER
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-2903
Country	:	US
Telephone Number	:	843-249-7232
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/08/2007

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