Provider Demographics
NPI:1538642368
Name:HOLLAND, KATHRYN TAYLOR (DPT, PT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TAYLOR
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14821 N HANA MAUI DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3656
Mailing Address - Country:US
Mailing Address - Phone:602-757-4631
Mailing Address - Fax:
Practice Address - Street 1:900 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1200
Practice Address - Country:US
Practice Address - Phone:800-606-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy