| Doctor Name: | HOLLY KRISTEN DICKSON |
| NPI Number: | 1013968882 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 1136273 |
| Business Practice Address: | 2800 E.state Hwy 114 Suite 220 Roanoke, TX - 762625624 |
| Business Phone Number: | 8174913403 |
| Business Fax Number: | 8174913308 |
| Mailing Address: | 311 Skyline Dr, TROPHY CLUB |
| State: | TX |
| Postal Code: | 762625624 |
| Phone Number: | 8177077025 |
| Fax Number: | 8174913807 |
| NPI Enumeration Date: | 05/15/2006 |
| NPI Last Update Date: | 06/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1136273 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |