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Individual

STEPHANIE W COLLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
96 OCEAN ST STE 4, SOUTH PORTLAND, ME 04106-2855
(207) 747-4455
(888) 907-5762
Mailing address
96 OCEAN ST STE 4, SOUTH PORTLAND, ME 04106-2855
(207) 747-4455
(888) 907-5762

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DO1663
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254890099
ME
Enumeration date
12/15/2005
Last updated
10/14/2024
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