Healthcare Provider Details

I. General information

NPI: 1356137921
Provider Name (Legal Business Name): JOAN C HOLLIS PT, DSC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 ALDERWOOD DR.
CHAGRIN FALLS OH
44022-4500
US

IV. Provider business mailing address

103 ALDERWOOD DR.
CHAGRIN FALLS OH
44022-4500
US

V. Phone/Fax

Practice location:
  • Phone: 440-376-8109
  • Fax:
Mailing address:
  • Phone: 440-376-8109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOAN COLETTE HOLLIS
Title or Position: OWNER
Credential: PT, DSC, FAAOMPT
Phone: 440-376-8109