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General NPI Number Information
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NPI Number | 1114080645
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Entity Type | Individual
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Provider Name | WES HOLLAND C.PED.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1758 PARK PL SUITE 300
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City | MONTGOMERY
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State | AL
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Zip | 36106-1127
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Country | US
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Telephone | 334-538-7696
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 STABLEWAY RD
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City | PIKE ROAD
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State | AL
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Zip | 36064-2764
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Country | US
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Telephone | 334-277-1551
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Fax | 909-740-2012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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