MEDICARE: MR. EDWARD G. HOLLAN OTR/L

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
1	225X00000X	Occupational Therapist	9376	NC
2	225X00000X	Occupational Therapist	31003568A	IN

General Provider Information

NPI Number	:	1851627087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD G. HOLLAN OTR/L

Provider Business Mailing Address
First Line	:	1053 N CHURCH ST
Second Line	:
City	:	AUSTIN
State	:	IN
Zip	:	47102-1001
Country	:	US
Telephone Number	:	812-595-7294
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 3RD ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-6967
Country	:	US
Telephone Number	:	336-890-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	04/28/2026

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