Provider Demographics
NPI:1497233316
Name:RAYNOR, HOLLEE (PTA, LMT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLEE
Middle Name:
Last Name:RAYNOR
Suffix:
Gender:F
Credentials:PTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 SPRING RUN LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2804
Mailing Address - Country:US
Mailing Address - Phone:937-478-1309
Mailing Address - Fax:
Practice Address - Street 1:75 HALE ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2104
Practice Address - Country:US
Practice Address - Phone:937-382-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5020225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant