Healthcare Provider Details

I. General information

NPI: 1427970086
Provider Name (Legal Business Name): ELLIE ROSE HOHLFELDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7951 KINGS HWY
KING GEORGE VA
22485-7075
US

IV. Provider business mailing address

128 NORTH BAY ROAD
LILY BAY TOWNSHIP ME
04441
US

V. Phone/Fax

Practice location:
  • Phone: 540-625-2311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217842
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: