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General NPI Number Information
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NPI Number | 1700083987
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Entity Type | Individual
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Provider Name | HOLLY HENDRICKSON PTA
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1804 WASHINGTON BLVD STE E
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City | BELPRE
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State | OH
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Zip | 45714-3501
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Country | US
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Telephone | 740-423-3084
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Fax | 740-423-5600
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Provider Business Mailing Address
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Address Line | 28378 TORCH RD
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City | COOLVILLE
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State | OH
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Zip | 45723-9706
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Country | US
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Telephone | 740-373-3597
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP010267A
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 004400
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License Number State | OH
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