Healthcare Provider Details

I. General information

NPI: 1871162560
Provider Name (Legal Business Name): HOLLY WRIGHT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY HEMBREE

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 N 14TH ST
PONCA CITY OK
74601-1841
US

IV. Provider business mailing address

1103 N 7TH ST
TONKAWA OK
74653-1519
US

V. Phone/Fax

Practice location:
  • Phone: 580-765-0101
  • Fax:
Mailing address:
  • Phone: 580-749-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5991
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: