| NPI | 1255855045 |
|---|---|
| Former Name | HOLLY HATCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13512) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 13512-24) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2019-12-19 |