Provider Demographics
NPI:1235980657
Name:CARLSMITH, HOLLY PILIALOHA
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:PILIALOHA
Last Name:CARLSMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 DEARBORN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7748
Mailing Address - Country:US
Mailing Address - Phone:406-543-7860
Mailing Address - Fax:
Practice Address - Street 1:2409 DEARBORN AVE STE E
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7748
Practice Address - Country:US
Practice Address - Phone:406-543-7860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-27465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist