| NPI | 1891078622 |
|---|---|
| Former Name | HOLLY HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012441) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT26820) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2013-11-22 |