| NPI | 1114018157 |
|---|---|
| Former Name | HOLLY JEAN MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10648) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 769-39) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-09-09 |