| NPI | 1467097790 |
|---|---|
| Former Name | HOLLY MARIE NETTEKOVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13513) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9987) |
| 225100000X Physical Therapist (Licence: GA PT014517) | |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2024-08-08 |