Provider Demographics
NPI:1063833861
Name:HOWARD, ZATARA HOLLAND (PT)
Entity Type:Individual
Prefix:MR
First Name:ZATARA
Middle Name:HOLLAND
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 HWY 119 S
Mailing Address - Street 2:P.O. BOX 386
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329-3021
Mailing Address - Country:US
Mailing Address - Phone:912-754-0428
Mailing Address - Fax:912-754-0471
Practice Address - Street 1:459 HWY 119 S
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-3021
Practice Address - Country:US
Practice Address - Phone:912-754-0428
Practice Address - Fax:912-754-0471
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist