Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 422 | AL |
NPI | 1093844805 |
---|---|
Provider Name | Ms. Deborah G. Collins |
First Address | Birmingham, AL 35226-3928 |
Second Address | Birmingham, AL 35226-3928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
510-72486 | BCBS PROVIDER NUMBER (01) | AL |