Healthcare Provider Details

I. General information

NPI: 1134530744
Provider Name (Legal Business Name): JENNIFER HOLLOWAY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER KULIK

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 COLSON LN
MULLICA HILL NJ
08062-1502
US

IV. Provider business mailing address

209 CREEK DR
GLASSBORO NJ
08028-3113
US

V. Phone/Fax

Practice location:
  • Phone: 856-347-7772
  • Fax:
Mailing address:
  • Phone: 856-347-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01319700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: