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NPI Code Detail

MEDICARE: SEON HOLLETT

MEDICARE: SEON HOLLETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2306603736VA

General Provider Information

NPI Number : 1679993976
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEON HOLLETT
Provider Business Mailing Address
First Line : 3901 SULGRAVE DR
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22309-2625
Country : US
Telephone Number : 703-989-3657
Fax Number :
Provider Business Practice Location Address
First Line : 3901 SULGRAVE DR
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22309-2625
Country : US
Telephone Number : 703-989-3657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2014
Last Update Date : 04/24/2014

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Directions to “ SEON HOLLETT ” Practice Location

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