Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 238351 | TX |
NPI | 1386162725 |
---|---|
Provider Name | Kristin Collins |
First Address | Plano, TX 75093-5195 |
Second Address | Allen, TX 75013-3744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2017 |
Last Update Date | 19/02/2019 |