Provider Demographics
NPI:1700899598
Name:HOLLAND, MICHELE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:VEILLEUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:29 RIVERSIDE ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062
Mailing Address - Country:US
Mailing Address - Phone:603-881-9990
Mailing Address - Fax:603-881-4191
Practice Address - Street 1:29 RIVERSIDE ST.
Practice Address - Street 2:SUITE C
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062
Practice Address - Country:US
Practice Address - Phone:603-881-9990
Practice Address - Fax:603-881-4191
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009157Medicaid
NHRE5575Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID