Healthcare Provider Details

I. General information

NPI: 1366212052
Provider Name (Legal Business Name): HOLLY JENNA SEXTON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY JENNA HAMM PT, DPT

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 THOMPSON ST STE B
HENDERSONVILLE NC
28792-2895
US

IV. Provider business mailing address

194 AIKEN RD
ROSMAN NC
28772-9762
US

V. Phone/Fax

Practice location:
  • Phone: 828-698-6774
  • Fax:
Mailing address:
  • Phone: 262-416-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP21540
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: