MEDICARE: MS. MARGARET HOLLIS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501005393	MI

General Provider Information

NPI Number	:	1063467215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET HOLLIS PT

Provider Business Mailing Address
First Line	:	26336 E HURON RIVER DR
Second Line	:	SUITE A
City	:	FLAT ROCK
State	:	MI
Zip	:	48134-1833
Country	:	US
Telephone Number	:	734-789-8281
Fax Number	:	734-789-8258

Provider Business Practice Location Address
First Line	:	26336 E HURON RIVER DR
Second Line	:	SUITE A
City	:	FLAT ROCK
State	:	MI
Zip	:	48134-1833
Country	:	US
Telephone Number	:	734-789-8281
Fax Number	:	734-789-8258

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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