Basic Information
| Provider Information | |||||||||
| NPI: | 1750438198 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLLOPY | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 MARKET ST | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402827386 | ||||||||
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| Practice Location | |||||||||
| Address1: | 560 STEUBENVILLE PIKE | ||||||||
| Address2: | |||||||||
| City: | BURGETTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249475350 | ||||||||
| FaxNumber: | 7249470206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 009788 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.