Provider Demographics
NPI:1154635316
Name:FURROW, HOLLEY H (PT)
Entity Type:Individual
Prefix:
First Name:HOLLEY
Middle Name:H
Last Name:FURROW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 HARPER PRIVATE DR
Mailing Address - Street 2:
Mailing Address - City:FRIERSON
Mailing Address - State:LA
Mailing Address - Zip Code:71027-1993
Mailing Address - Country:US
Mailing Address - Phone:318-925-4260
Mailing Address - Fax:
Practice Address - Street 1:158 HARPER PRIVATE DR
Practice Address - Street 2:
Practice Address - City:FRIERSON
Practice Address - State:LA
Practice Address - Zip Code:71027-1993
Practice Address - Country:US
Practice Address - Phone:318-925-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2019-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02613225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist