Provider Demographics
NPI:1790720407
Name:HOLLEY, RICHARD JAMES
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:JAMES
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4104 LOMAR TER
Mailing Address - Street 2:GREENS AT MANORWOOD
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-3909
Mailing Address - Country:US
Mailing Address - Phone:301-829-6779
Mailing Address - Fax:301-754-7342
Practice Address - Street 1:1500 FOREST GLEN RD
Practice Address - Street 2:PHYSICAL MEDICINE AND REHAB DPT
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1483
Practice Address - Country:US
Practice Address - Phone:301-754-7340
Practice Address - Fax:301-754-7342
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03635171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider