Doctor Name: | BRADLEY EDWARD HOLLAND |
NPI Number: | 1477920544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 4696 |
Business Practice Address: | 817 W Cherokee St Wagoner, OK - 744674616 |
Business Phone Number: | 9184853100 |
Business Fax Number: | 9184853126 |
Mailing Address: | 4812 E 33rd St, TULSA |
State: | OK |
Postal Code: | 741352038 |
Phone Number: | 9186224126 |
Fax Number: | 9182702398 |
NPI Enumeration Date: | 08/25/2015 |
NPI Last Update Date: | 08/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4696 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
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 |