Provider Demographics
NPI:1508473257
Name:FLINTALL, HOLLY (DPT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:FLINTALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:DOMBROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2895 LOMA VISTA RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-765-4773
Mailing Address - Fax:
Practice Address - Street 1:2895 LOMA VISTA RD
Practice Address - Street 2:SUITE H
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-765-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist