| NPI | 1932457330 |
|---|---|
| Former Name | HOLLY WILES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29680) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04437) |
| 225100000X Physical Therapist (Licence: MO 2012015111) | |
| 225100000X Physical Therapist (Licence: OK 4421) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2015-11-24 |