Provider Demographics
NPI:1467805499
Name:FLIPPO, HOLLI LANEA (DPT)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:LANEA
Last Name:FLIPPO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 GOLDEN ST APT 6
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-5244
Mailing Address - Country:US
Mailing Address - Phone:615-717-7423
Mailing Address - Fax:
Practice Address - Street 1:8540 GOLDEN ST APT 6
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5244
Practice Address - Country:US
Practice Address - Phone:615-717-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25985225100000X
AK161452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist