Provider Demographics
NPI:1205018272
Name:KROLAND, HOLLY (OTR/L)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:KROLAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PARDO RD
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-3434
Mailing Address - Country:US
Mailing Address - Phone:864-457-7363
Mailing Address - Fax:
Practice Address - Street 1:1 CREEKVIEW CT
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4839
Practice Address - Country:US
Practice Address - Phone:864-286-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3104172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist