Provider Demographics
NPI:1164779922
Name:MULLANEY, HOLLY CLAIRE (DPT)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:CLAIRE
Last Name:MULLANEY
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 1:125 RIVERDALE CIR
Mailing Address - Street 2:
Mailing Address - City:STEPHENSON
Mailing Address - State:VA
Mailing Address - Zip Code:22656-2118
Mailing Address - Country:US
Mailing Address - Phone:540-303-1432
Mailing Address - Fax:
Practice Address - Street 1:125 RIVERDALE CIR
Practice Address - Street 2:
Practice Address - City:STEPHENSON
Practice Address - State:VA
Practice Address - Zip Code:22656-2118
Practice Address - Country:US
Practice Address - Phone:540-303-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004480225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist