Provider Demographics
NPI:1154357333
Name:MINOR, COLLEEN M (MPT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:MINOR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:M
Other - Last Name:CROMWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1555 KUHLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6621
Mailing Address - Country:US
Mailing Address - Phone:412-367-3957
Mailing Address - Fax:
Practice Address - Street 1:111 PERRYMONT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5246
Practice Address - Country:US
Practice Address - Phone:412-348-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013999L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist