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Individual

MR. EDWARD NATHAN COLLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1550 BUSINESS CENTER DR, SUITE B, ORANGE PARK, FL 32003-7450
(904) 264-6304
Mailing address
2130 SALT MYRTLE LN, ORANGE PARK, FL 32003-7074
(904) 264-6304

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6605
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y904L
BCBS PROVIDER NUMBER
FL
Enumeration date
02/14/2006
Last updated
09/08/2010
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