Provider Demographics
NPI:1639361207
Name:HOLLYFIELD PHYSICAL THERAPY, LLC.
Entity Type:Organization
Organization Name:HOLLYFIELD PHYSICAL THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLLYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:301-292-4074
Mailing Address - Street 1:821 BRYAN POINT ROAD
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607
Mailing Address - Country:US
Mailing Address - Phone:301-292-4074
Mailing Address - Fax:301-292-4074
Practice Address - Street 1:821 BRYAN POINT RD
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-2348
Practice Address - Country:US
Practice Address - Phone:301-292-4074
Practice Address - Fax:301-292-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15965261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy