Individual
NICOLE MARIE COLLURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4210 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078-2580
(610) 769-4111
Mailing address
3687 TAMPA RD, OLDSMAR, FL 34677
(813) 471-0152
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
211496
TX
224Z00000X
Occupational Therapy Assistant
Primary
TOP008311
PA
Other
Enumeration date
06/21/2011
Last updated
11/05/2014
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