Provider Demographics
NPI:1538111372
Name:HOLLAND, GINA M (LPT)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 CAROLINA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6000
Mailing Address - Country:US
Mailing Address - Phone:336-275-6380
Mailing Address - Fax:336-275-6381
Practice Address - Street 1:1313 CAROLINA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6000
Practice Address - Country:US
Practice Address - Phone:336-275-6380
Practice Address - Fax:336-275-6381
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC078H6OtherBCBS PROVIDER NUMBER