Provider Demographics
NPI:1508163288
Name:HOLLINGSHEAD, CHRISTY GAYLE (MSPT)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:GAYLE
Last Name:HOLLINGSHEAD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 BETHLEHEM RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:AR
Mailing Address - Zip Code:72007-8971
Mailing Address - Country:US
Mailing Address - Phone:501-837-5030
Mailing Address - Fax:
Practice Address - Street 1:207 FRED RAINS DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5457
Practice Address - Country:US
Practice Address - Phone:501-834-0217
Practice Address - Fax:501-833-0957
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139373721Medicaid