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NPI Code Detail

MEDICARE: PAUL D HOLLAND PT

MEDICARE: PAUL D HOLLAND 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 TherapistPT2442FL

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 : 1689677858
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL D HOLLAND PT
Provider Business Mailing Address
First Line : 752 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3282
Country : US
Telephone Number : 386-734-1136
Fax Number : 386-734-2262
Provider Business Practice Location Address
First Line : 752 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3282
Country : US
Telephone Number : 386-734-1136
Fax Number : 386-734-2262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/04/2009

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Directions to “ PAUL D HOLLAND PT” Practice Location

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