Doctor Name: | MRS. SHARON K. HOLY |
NPI Number: | 1649450222 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 2281-024 |
Business Practice Address: | 1351 Wisconsin River Dr Port Edwards, WI - 544691041 |
Business Phone Number: | 7158858300 |
Business Fax Number: | 7158858350 |
Mailing Address: | 1351 Wisconsin River Dr, PORT EDWARDS |
State: | WI |
Postal Code: | 544691041 |
Phone Number: | 7158858300 |
Fax Number: | 7158858350 |
NPI Enumeration Date: | 11/12/2007 |
NPI Last Update Date: | 11/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | 2281-024 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |