Provider Demographics
NPI:1457707028
Name:HOLLAND, STEPHEN BRETT (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRETT
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:5665 DALLAS PKWY
Practice Address - Street 2:STE 110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7372
Practice Address - Country:US
Practice Address - Phone:972-979-6577
Practice Address - Fax:972-979-6951
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1246401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist