Provider Demographics
NPI:1225398308
Name:WALKER, HOLLY LOUISE (CMT)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:LOUISE
Last Name:WALKER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 FRANCE AVE S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4525
Mailing Address - Country:US
Mailing Address - Phone:952-288-2230
Mailing Address - Fax:952-288-2226
Practice Address - Street 1:7300 FRANCE AVE S
Practice Address - Street 2:SUITE 300
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4525
Practice Address - Country:US
Practice Address - Phone:952-288-2230
Practice Address - Fax:952-288-2226
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN606061-11225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist