Healthcare Provider Details

I. General information

NPI: 1851537492
Provider Name (Legal Business Name): KATHLEEN ANNE HOLLAND-NOLL P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2009
Last Update Date: 01/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 HIGHWAY 202/206
BRIDGEWATER NJ
08807-1767
US

IV. Provider business mailing address

18 TERRACE LN
BRIDGEWATER NJ
08807-5603
US

V. Phone/Fax

Practice location:
  • Phone: 908-252-3400
  • Fax:
Mailing address:
  • Phone: 908-725-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00482000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: