Healthcare Provider Details

I. General information

NPI: 1013115567
Provider Name (Legal Business Name): HOLLY MCCROSKEY NEWTON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS HOLLY LANSE MCCROSKEY

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E DUNLAP
PHX SCOTTSDALE AZ
85020
US

IV. Provider business mailing address

6802 N 10TH AVENUE
PHOENIX AZ
85013
US

V. Phone/Fax

Practice location:
  • Phone: 602-870-6060
  • Fax: 602-870-6058
Mailing address:
  • Phone: 602-279-9641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4233
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: