Provider Demographics
NPI:1275912586
Name:WILLIAMS, HOLLY MARGARET (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARGARET
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARGARET
Other - Last Name:WALTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:7414 LEGACY ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4244
Mailing Address - Country:US
Mailing Address - Phone:402-212-4876
Mailing Address - Fax:
Practice Address - Street 1:701 OLSON DR STE 108
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4797
Practice Address - Country:US
Practice Address - Phone:402-212-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33612251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025611000Medicaid