Provider Demographics
NPI:1437303260
Name:DEAR, HOLLY C (MPT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:C
Last Name:DEAR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:C
Other - Last Name:SPRUILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:PO BOX 12969
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2969
Mailing Address - Country:US
Mailing Address - Phone:252-636-9800
Mailing Address - Fax:252-636-1945
Practice Address - Street 1:2305 EXECUTIVE PARK CIRCLE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3768
Practice Address - Country:US
Practice Address - Phone:252-329-8800
Practice Address - Fax:252-329-8866
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212815Medicaid
NC2506207Medicare UPIN