Healthcare Provider Details

I. General information

NPI: 1497797955
Provider Name (Legal Business Name): HOLLY HERSHBERGER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 DOWNS DR
CHANTILLY VA
20151-3308
US

IV. Provider business mailing address

8254 ATLEE RD
MECHANICSVILLE VA
23116-1844
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 804-342-4300
  • Fax: 804-342-4316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203881
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: