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General NPI Number Information
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NPI Number | 1134179088
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Entity Type | Individual
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Provider Name | KRISTEN RENEE HOLLOWAY PT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 211 BOBBY JONES EXPRESSWAY SUITE C
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City | MARTINEZ
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State | GA
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Zip | 30907
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Country | US
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Telephone | 706-364-5533
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Fax | 704-860-8765
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Provider Business Mailing Address
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Address Line | 211 BOBBY JONES EXPRESSWAY SUITE C
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City | MARTINEZ
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State | GA
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Zip | 30907
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Country | US
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Telephone | 706-364-5533
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Fax | 706-860-8765
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 6087
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT009305
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License Number State | GA
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