Provider Demographics
NPI:1053056077
Name:ELWOOD, HOLLIE ANN (DPT)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:ANN
Last Name:ELWOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 WIMBLEDON RD
Mailing Address - Street 2:
Mailing Address - City:EPSOM
Mailing Address - State:NH
Mailing Address - Zip Code:03234-4439
Mailing Address - Country:US
Mailing Address - Phone:978-328-4420
Mailing Address - Fax:
Practice Address - Street 1:75 WIMBLEDON RD
Practice Address - Street 2:
Practice Address - City:EPSOM
Practice Address - State:NH
Practice Address - Zip Code:03234-4439
Practice Address - Country:US
Practice Address - Phone:978-328-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist