Healthcare Provider Details

I. General information

NPI: 1912554528
Provider Name (Legal Business Name): ABIGAIL HOLLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 KARL RD
COLUMBUS OH
43229-3602
US

IV. Provider business mailing address

2232 JARROW DR
HILLIARD OH
43026-8732
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-5420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT.012965
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: