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NPI Code Detail

MEDICARE: HOLLY JANE MCWHORTER PT

MEDICARE: HOLLY JANE MCWHORTER 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
1225100000XPhysical TherapistPT005870GA
2225100000XPhysical TherapistPT35702FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679579866
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY JANE MCWHORTER PT
Provider Business Mailing Address
First Line : PO BOX 949
Second Line :
City : ROME
State : GA
Zip : 30162-0949
Country : US
Telephone Number : 904-261-4664
Fax Number : 904-261-5852
Provider Business Practice Location Address
First Line : 1897 ISLAND WALK WAY STE 5
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-1949
Country : US
Telephone Number : 904-261-4664
Fax Number : 904-261-5852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 08/21/2020

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Directions to “ HOLLY JANE MCWHORTER PT” Practice Location

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